A Call for the Aggressive Treatment of Oligometastatic and Oligo-Recurrent Non-Small Cell Lung Cancer
Metastatic non-small cell lung cancer (NSCLC) carries a dismal prognosis. Clinical evidence suggests the existence of an intermediate, or oligometastatic, state when metastases are limited in number and/or location. In addition, following initial curative therapy, many patients present with limited...
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doaj-f420df7f663c41f8ba61f9af515f9fd82020-11-25T00:35:48ZengHindawi LimitedPulmonary Medicine2090-18362090-18442012-01-01201210.1155/2012/480961480961A Call for the Aggressive Treatment of Oligometastatic and Oligo-Recurrent Non-Small Cell Lung CancerPretesh R. Patel0David S. Yoo1Yuzuru Niibe2James J. Urbanic3Joseph K. Salama4Department of Radiation Oncology, Duke University, P.O. Box 3085, Durham NC 27713, USADepartment of Radiation Oncology, Duke University, P.O. Box 3085, Durham NC 27713, USADepartment of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara 252-0374, JapanDepartment of Radiation Oncology, Wake Forest University, Winston-Salem, NC 27157, USADepartment of Radiation Oncology, Duke University, P.O. Box 3085, Durham NC 27713, USAMetastatic non-small cell lung cancer (NSCLC) carries a dismal prognosis. Clinical evidence suggests the existence of an intermediate, or oligometastatic, state when metastases are limited in number and/or location. In addition, following initial curative therapy, many patients present with limited metastatic disease, or oligo-recurrence. Metastasis-directed, anti-cancer therapies may benefit these patients. A growing evidence-base supports the use of hypofractionated, image-guided radiotherapy (HIGRT) for a variety of malignant conditions including inoperable stage I NSCLC and many metastatic sites. When surgical resection is not possible, HIGRT offers an effective alternative for local treatment of limited metastatic disease. Early studies have produced promising results when HIGRT was delivered to all known sites of disease in patients with oligometastatic/oligo-recurrent NSCLC. In a population of patients formerly considered rapidly terminal, these studies report five year overall survival rates of 13–22%. HIGRT for metastatic NSCLC warrants further study. We call for large, intergroup, and even international randomized trials incorporating HIGRT and other metastasis-directed therapies into the treatment of patients with oligometastatic/oligo-recurrent NSCLC.http://dx.doi.org/10.1155/2012/480961 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pretesh R. Patel David S. Yoo Yuzuru Niibe James J. Urbanic Joseph K. Salama |
spellingShingle |
Pretesh R. Patel David S. Yoo Yuzuru Niibe James J. Urbanic Joseph K. Salama A Call for the Aggressive Treatment of Oligometastatic and Oligo-Recurrent Non-Small Cell Lung Cancer Pulmonary Medicine |
author_facet |
Pretesh R. Patel David S. Yoo Yuzuru Niibe James J. Urbanic Joseph K. Salama |
author_sort |
Pretesh R. Patel |
title |
A Call for the Aggressive Treatment of Oligometastatic and Oligo-Recurrent Non-Small Cell Lung Cancer |
title_short |
A Call for the Aggressive Treatment of Oligometastatic and Oligo-Recurrent Non-Small Cell Lung Cancer |
title_full |
A Call for the Aggressive Treatment of Oligometastatic and Oligo-Recurrent Non-Small Cell Lung Cancer |
title_fullStr |
A Call for the Aggressive Treatment of Oligometastatic and Oligo-Recurrent Non-Small Cell Lung Cancer |
title_full_unstemmed |
A Call for the Aggressive Treatment of Oligometastatic and Oligo-Recurrent Non-Small Cell Lung Cancer |
title_sort |
call for the aggressive treatment of oligometastatic and oligo-recurrent non-small cell lung cancer |
publisher |
Hindawi Limited |
series |
Pulmonary Medicine |
issn |
2090-1836 2090-1844 |
publishDate |
2012-01-01 |
description |
Metastatic non-small cell lung cancer (NSCLC) carries a dismal prognosis. Clinical evidence suggests the existence of an intermediate, or oligometastatic, state when metastases are limited in number and/or location. In addition, following initial curative therapy, many patients present with limited metastatic disease, or oligo-recurrence. Metastasis-directed, anti-cancer therapies may benefit these patients. A growing evidence-base supports the use of hypofractionated, image-guided radiotherapy (HIGRT) for a variety of malignant conditions including inoperable stage I NSCLC and many metastatic sites. When surgical resection is not possible, HIGRT offers an effective alternative for local treatment of limited metastatic disease. Early studies have produced promising results when HIGRT was delivered to all known sites of disease in patients with oligometastatic/oligo-recurrent NSCLC. In a population of patients formerly considered rapidly terminal, these studies report five year overall survival rates of 13–22%. HIGRT for metastatic NSCLC warrants further study. We call for large, intergroup, and even international randomized trials incorporating HIGRT and other metastasis-directed therapies into the treatment of patients with oligometastatic/oligo-recurrent NSCLC. |
url |
http://dx.doi.org/10.1155/2012/480961 |
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