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

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 radio...

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Published in:Medical oncology (Northwood, London, England) London, England), 2018-11, Vol.35 (11), p.146-11, Article 146
Main Authors: Diletto, Barbara, Dinapoli, Nicola, Chiesa, Silvia, Mattiucci, Gian Carlo, Frascino, Vincenzo, Anile, Carmelo, Colosimo, Cesare, Valentini, Vincenzo, Balducci, Mario
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Calibration
Female
Follow-Up Studies
Hematology
Humans
Internal Medicine
Male
Medicine
Medicine & Public Health
Metastasis
Middle Aged
Models, Theoretical
Neoplasms - diagnosis
Neoplasms - therapy
Oncology
Original Paper
Pathology
Predictive Value of Tests
Radiation Dose Hypofractionation
Radiation therapy
Radiosurgery - methods
Radiotherapy Dosage
Retrospective Studies
Treatment Outcome
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Summary: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 (BED 10 ), and as ratio between BED 10 and the logarithm of metastasis volume (BED 10 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. BED 10 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 BED 10 -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 BED 10 model ( p value 
ISSN:1357-0560
1559-131X
DOI:10.1007/s12032-018-1206-4