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Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review

In recent years, the concept of oligometastases has become accepted and reports on stereotactic body radiotherapy as a treatment method have been published. Lesions in the brain, lung, and liver have been reported as target lesions. However, lymph node oligometastases could be a good candidate for s...

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Autores principales: Matsushita, Haruo, Jingu, Keiichi, Umezawa, Rei, Yamamoto, Takaya, Ishikawa, Yojiro, Takahashi, Noriyoshi, Katagiri, Yu, Kadoya, Noriyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201169/
https://www.ncbi.nlm.nih.gov/pubmed/30352542
http://dx.doi.org/10.1177/1533033818803597
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author Matsushita, Haruo
Jingu, Keiichi
Umezawa, Rei
Yamamoto, Takaya
Ishikawa, Yojiro
Takahashi, Noriyoshi
Katagiri, Yu
Kadoya, Noriyuki
author_facet Matsushita, Haruo
Jingu, Keiichi
Umezawa, Rei
Yamamoto, Takaya
Ishikawa, Yojiro
Takahashi, Noriyoshi
Katagiri, Yu
Kadoya, Noriyuki
author_sort Matsushita, Haruo
collection PubMed
description In recent years, the concept of oligometastases has become accepted and reports on stereotactic body radiotherapy as a treatment method have been published. Lesions in the brain, lung, and liver have been reported as target lesions. However, lymph node oligometastases could be a good candidate for stereotactic body radiotherapy as well. In this study, the usability of stereotactic body radiotherapy for oligometastases to lymph nodes is assessed by researching for each primary site. As a result, we could consider that stereotactic body radiotherapy could be almost well applied for lymph node oligometastases from the breast, gynecological organs, and prostate. However, doubts remain concerning the usefulness of stereotactic body radiotherapy for cervical node metastases from head and neck cancer or for mediastinal node metastases from lung or esophageal cancer since late toxicities have occurred with a large radiation dose at hypofractionation to major vessels or the central respiratory tract, especially in patients with irradiation histories. In addition, high-dose irradiation is required to control lymph node metastases from colorectal cancer due to its radioresistance, and severe late adverse events would therefore occur in adjacent organs such as the gastrointestinal tract. In cases of lymph node oligometastases with a primary tumor in the stomach or esophagus, stereotactic body radiotherapy should be used limitedly at present because this patient population is not so large and these metastases are often located close to organs at risk. Because of the varied status of recurrence and varied conditions of patients, it is difficult to determine the optimal dose for tumor control. It might be reasonable to determine the treatment dose individually based on dose constraints of adjacent organs. The oligometastatic state is becoming more frequently identified with more sensitive methods of detecting such oligometastases. In addition, there seems to be another type of oligometastases, so-called induced oligometastases, following successful systemic treatment. To determine the optimal indication of stereotactic body radiotherapy for lymph node oligometastases, further investigation about the mechanisms of oligometastases and further clinical studies including a phase III study are needed.
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spelling pubmed-62011692018-10-26 Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review Matsushita, Haruo Jingu, Keiichi Umezawa, Rei Yamamoto, Takaya Ishikawa, Yojiro Takahashi, Noriyoshi Katagiri, Yu Kadoya, Noriyuki Technol Cancer Res Treat Review In recent years, the concept of oligometastases has become accepted and reports on stereotactic body radiotherapy as a treatment method have been published. Lesions in the brain, lung, and liver have been reported as target lesions. However, lymph node oligometastases could be a good candidate for stereotactic body radiotherapy as well. In this study, the usability of stereotactic body radiotherapy for oligometastases to lymph nodes is assessed by researching for each primary site. As a result, we could consider that stereotactic body radiotherapy could be almost well applied for lymph node oligometastases from the breast, gynecological organs, and prostate. However, doubts remain concerning the usefulness of stereotactic body radiotherapy for cervical node metastases from head and neck cancer or for mediastinal node metastases from lung or esophageal cancer since late toxicities have occurred with a large radiation dose at hypofractionation to major vessels or the central respiratory tract, especially in patients with irradiation histories. In addition, high-dose irradiation is required to control lymph node metastases from colorectal cancer due to its radioresistance, and severe late adverse events would therefore occur in adjacent organs such as the gastrointestinal tract. In cases of lymph node oligometastases with a primary tumor in the stomach or esophagus, stereotactic body radiotherapy should be used limitedly at present because this patient population is not so large and these metastases are often located close to organs at risk. Because of the varied status of recurrence and varied conditions of patients, it is difficult to determine the optimal dose for tumor control. It might be reasonable to determine the treatment dose individually based on dose constraints of adjacent organs. The oligometastatic state is becoming more frequently identified with more sensitive methods of detecting such oligometastases. In addition, there seems to be another type of oligometastases, so-called induced oligometastases, following successful systemic treatment. To determine the optimal indication of stereotactic body radiotherapy for lymph node oligometastases, further investigation about the mechanisms of oligometastases and further clinical studies including a phase III study are needed. SAGE Publications 2018-10-23 /pmc/articles/PMC6201169/ /pubmed/30352542 http://dx.doi.org/10.1177/1533033818803597 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Matsushita, Haruo
Jingu, Keiichi
Umezawa, Rei
Yamamoto, Takaya
Ishikawa, Yojiro
Takahashi, Noriyoshi
Katagiri, Yu
Kadoya, Noriyuki
Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review
title Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review
title_full Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review
title_fullStr Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review
title_full_unstemmed Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review
title_short Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review
title_sort stereotactic radiotherapy for oligometastases in lymph nodes—a review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201169/
https://www.ncbi.nlm.nih.gov/pubmed/30352542
http://dx.doi.org/10.1177/1533033818803597
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