To assess the efficacy of progression-directed radiation therapy (PDRT) in patients with oligoprogressive non-small cell lung cancer (NSCLC), focusing on disease progression and changes in systemic therapy, and to evaluate its significance in current treatment paradigms.
Key Findings:
Eighty-seven patients were included with a median age of 68 years and a median follow-up of 14 months (range: 1-48 months).
PDRT was administered after first-line systemic therapy in 70.1% of patients.
One-year actuarial EFS rate was 52.1%.
PDRT directed at the primary tumor and achieving a complete response prior to oligoprogression were associated with improved EFS.
Chemotherapy use and larger CTV volumes were associated with worse outcomes.
Interpretation:
PDRT achieved a median EFS of 5 months and extended the median time to next systemic therapy to 8 months, suggesting it may help maintain disease control in oligoprogressive NSCLC, with implications for clinical practice.
Limitations:
Retrospective design may introduce bias.
Limited sample size and single-center study may affect generalizability.
Lack of long-term follow-up data.
Potential confounding factors not controlled for in the analysis.
Conclusion:
PDRT may represent an effective approach to maintaining disease control and postponing systemic treatment in oligoprogressive NSCLC, warranting larger, prospective studies.
by Lorenzo De Sanctis, Riccardo Ray Colciago, Giulia Rossano, Matteo Ferrari, Matteo Mombelli, Ilenia Manno, Federica Ferrario, Sara Saufi, Valeria Faccenda, Denis Panizza, Gaia Passarella, Stefania Canova, Diego Luigi Cortinovis, Stefano Arcangeli
