ArticleCancer medicine2021
Volumetric burden of metastatic lesions drives outcomes in patients with extracranial oligometastatic disease.
Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Skeletal metastatic burden as a strong prognostic factor of survival in advanced NSCLC treated with chemo-immunotherapy: An exploratory imaging-based analysis.Journal of bone oncology · 2026Article
- Prognostic factors for local failure and overall survival in patients with epidural disease at the cauda equina following stereotactic body radiotherapy: a clinical, anatomic and dosimetric analysis.Journal of neuro-oncology · 2025Article
- Long-term survival and undetectable circulating tumor DNA following comprehensive involved site radiotherapy for oligometastases.Scientific reports · 2025Article
- International consensus on radiotherapy in metastatic non-small cell lung cancer.Translational lung cancer research · 2022Review
- Volumetric burden of metastatic lesions drives outcomes in patients with extracranial oligometastatic disease.Cancer medicine · 2021Article
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Authors and funding
12 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe hypothesized that the total volume of metastases at initial oligometastatic (OM) presentation to stereotactic body radiation therapy (SBRT) is an important prognostic factor that can refine the definition of OM disease.
methodsPatients with extracranial oligometastatic cancer (≤5 lesions) treated with SBRT were included in an international multi-institutional database. Multivariable Cox and competing risks regression models were used to determine the relationship between distant progression-free survival (DPFS), widespread progression (WSP), and overall survival (OS) with the total planning target volume (PTV) at initial OM presentation to SBRT. All models were adjusted for histology, pre-SBRT systemic therapy, osseous-only lesions, and number of metastases.
resultsIn total, 961 patients were included. The median follow-up was 24.4 months (IQR: 13.8-37.5). Total PTV had a significant effect on DPFS in the first 18 months after SBRT and was most profound in the first 6 months, when each twofold increase in total PTV conferred a 40.6% increased risk of distant progression (p < 0.001). Each twofold increase in total PTV increased the risk of WSP by 45.4% in the first 6 months (p < 0.001). Total PTV had a significant effect on OS in the first 2 years after SBRT, with each twofold PTV change increasing the risk of death by 60.7% during the first 6 months (p < 0.001) and by 34% thereafter (p < 0.001). Exploratory gross tumor volume (GTV) analysis confirmed the PTV-based observations.
conclusionThe total volumetric burden of metastases at initial OM presentation to SBRT is strongly and independently prognostic for the risk of distant and widespread progression and survival. We propose that this metric should drive the definition of OM disease and guide treatment decision-making.
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