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Hypofractionated stereotactic radiotherapy for oligometastatic patients: developing of a response predictive model

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Abstract

Objectives

Treatment of oligometastatic patients is a current challenge in radiation oncology. Aim of this study is to define a dose–response relationship for hypofractionated radiotherapy of oligometastases.

Methods

Retrospective analysis of metastases treated by hypofractionated stereotactic radiotherapy was performed. Delivered dose was calculated both as biological effective dose (BED10), and as ratio between BED10 and the logarithm of metastasis volume (BED10 logVolume Ratio, BVR). Two dose–response models were defined by logistic regression. The fitted outcome was the Metastases Complete Response (MCR). Performances of the models were assessed by area under the receiver operating curve (AUC) and by bootstrap calibration of original data. BED10 and BVR impact on survival outcomes has been evaluated.

Results

Fifty-three patients with 79 metastases were analyzed. AUC and calibration of BVR-based logistic model showed better accuracy in predicting MCR with respect to BED10-based model. No significant difference between the two ROCs was observed (De Long test p value > 0.05), but significant discordance in calibration resulted in the BED10 model (p value < 0.05 in Hosmer–Lemeshow Goodness of fit test). BVR returned also better results in multivariate analyses for survival outcomes.

Conclusions

The ratio between BED10 and the logarithm of metastasis volume (BVR), as a corrective factor for fitting the probability of metastases response to stereotactic radiotherapy, could be a tool for evaluating and prescribing treatments for oligometastatic disease. BVR can be useful for producing more reliable survival statistics too.

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Author notes

  1. Barbara Diletto

    Present address: Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, Italy

Authors and Affiliations

  1. Department of Radiation Oncology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, Rome, Italy

    Barbara Diletto, Nicola Dinapoli, Silvia Chiesa, Gian Carlo Mattiucci, Vincenzo Frascino, Vincenzo Valentini & Mario Balducci

  2. Department of Neurosurgery, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, Rome, Italy

    Carmelo Anile

  3. Department of Radiology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, Rome, Italy

    Cesare Colosimo

Authors
  1. Barbara Diletto
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  2. Nicola Dinapoli
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  3. Silvia Chiesa
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  4. Gian Carlo Mattiucci
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  8. Vincenzo Valentini
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Corresponding author

Correspondence to Barbara Diletto.

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The authors declare that they have no conflict of interest.

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For this study, institutional review and patient informed consent were not required.

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Diletto, B., Dinapoli, N., Chiesa, S. et al. Hypofractionated stereotactic radiotherapy for oligometastatic patients: developing of a response predictive model. Med Oncol 35, 146 (2018). https://doi.org/10.1007/s12032-018-1206-4

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  • DOI: https://doi.org/10.1007/s12032-018-1206-4

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