Oligometastatic disease, the curative challenge in radiation oncology

作     者：Amalia Palacios-Eito Sonia García-Cabezas 

作者机构：Servicio de Oncología Radioterápica Hospital Universitario Reina Sofía 

出 版 物：《World Journal of Clinical Oncology》 (世界临床肿瘤学杂志（英文版）)

年 卷 期：2015年第6卷第4期

页      面：30-34页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 1001[医学-基础医学(可授医学、理学学位)] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100106[医学-放射医学] 10[医学] 

主　　题：Oligometastases Radiotherapy Stereotactic body radiotherapy Stereotactic body radiation therapy Stereotactic ablative body radiotherapy Curative intent 

摘      要：The concept of oligometastatic disease was first described by Hellman and Weichselbaum in 1995. The mere insight of this concept led to the hypothesis that this disease may be cured using local ablative weapons. Surgery has already demonstrated this hypothesis. Surgery limitations, either technical or due to refusalor associated comorbidity, have led to implement alternative ablative options such as stereotactic body radiation therapy(SBRT). SBRT evolved from(stereotactic radiosurgery) because of the need to irradiate extracranial lesions and has been shown to be safe and effective. SBRT achieves local control rates ranging from 70%-90%, but highly variable survival rates depending on the group analyzed. Series with heterogeneous metastatic sites and tumor origin have reported 20% survival rates at 2-3 years, similar to those achieved with surgery. Despite its excellent results, SBRT still faces significant clinical challenges. Its optimal integration with systemic treatment is unknown, and response assessment is very difficult. However, the greatest challenge lies in selection of patients most likely to remain oligometastatic, those who will most benefit from the technique. Biomarkers, molecular signatures, that accurately predict the biological behavior of malignancy are needed. The expression profile of specific mi RNAs has been shown to have a potential in this regard.