Radical treatment of non-small-cell lung cancer patients with synchronous oligometastases: long-term results of a prospective phase II trial (Nct01282450)
Open accessAbstract
Background Stage IV non-small-cell lung cancer (NSCLC) patients with oligometastases (< 5 metastatic lesions) may experience long-term survival when all macroscopic tumor sites are treated radically, but no prospective data on NSCLCs with synchronous oligometastases are available.Methods A prospective single-arm phase II trial was conducted. The main inclusion criteria were pathologically proven NSCLC stage IV with less than five metastases at primary diagnosis, amendable for radical local treatment (surgery or radiotherapy). The study is listed in clinicaltrials.gov, number NCT01282450.Results Forty patients were enrolled, 39 of whom were evaluable (18 men, 21 women); mean age was 62.1 ± 9.2 years (range, 44-81). Twenty-nine (74%) had local stage III; 17 (44%) brain, seven (18%) bone, and four (10%) adrenal gland metastases. Thirty-five (87%) had a single metastatic lesion. Thirty-seven (95%) of the patients received chemotherapy as part of their primary treatment. Median overall survival (OS) was 13.5 months (95% confidence interval 7.6-19.4); 1-, 2-, and 3-year OS was 56.4%, 23.3%, and 17.5%, respectively. Median progression-free survival (PFS) was 12.1 months (95% confidence interval 9.6-14.3); 1-year PFS was 51.3%, and both 2- and 3-year PFS was 13.6%. Only two patients (5%) had a local recurrence. No patient or tumor parameter, including volume and F-deoxyglucose uptake was significantly correlated with OS or PFS. The treatment was well tolerated.Conclusion In this phase II study, long-term PFS was found in a subgroup of NSCLC patients with synchronous oligometastases when treated radically. Identification of this favorable subgroup before therapy is needed.
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In a prospective single-arm phase II trial, after systemic treatment and radical local radiotherapy or surgery of all tumour lesions, 13% of patients remained disease free at 3 years.
“With systemic treatment and radical local radiotherapy (brain SRS or high-dose fractionated radiotherapy) or surgery of all tumour lesions, the trial reported that 13% of patients remained disease free at 3 years.”
From Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up (2016) · cites this paper as [173]
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- Authors
- De Ruysscher, D., Wanders, R., van Baardwijk, A., Dingemans, A.-M. C., Reymen, B., Houben, R., Bootsma, G., Pitz, C., van Eijsden, L., Geraedts, W., Baumert, B. G., & Lambin, P.
- Affiliations
- Maastricht University Medical Centre (NL)
- Atrium Medisch Centrum Parkstad (NL)
- Laurentius Ziekenhuis (NL)
- Zuyderland Medisch Centrum (NL)
- ORCID
- Venue
- Journal of Thoracic Oncology
- Publisher
- Elsevier BV
- Published
- 2012-10
- Volume
- 7
- Issue
- 10
- Pages
- 1547-1555
- ISSN
- 1556-0864 (ISSN-L)
- OpenAlex
- W1987288037
- Cited by
- 283
- References
- 48
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 10 · 2023: 15 · 2022: 17 · 2021: 22 · 2020: 17 · 2019: 37 · 2018: 37 · 2017: 18 · 2016: 31 · 2015: 17 · 2014: 27 · 2013: 15 · 2012: 3
- FWCI
- 15.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thoracic Oncology (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
- Keywords
- non-small cell lung cancer, oligometastatic disease, synchronous metastases, stage IV lung cancer, metastasectomy, stereotactic body radiotherapy, overall survival, progression-free survival, brain metastases, bone metastasis, adrenal metastasis, prognostic factors, FDG-PET
- MeSH terms
- Adenocarcinoma, Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Prospective Studies, Risk Factors, Time Factors, Survival Rate, Radiosurgery, Carcinoma, Large Cell
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