Stereotactic body radiation therapy for thoracic and abdominal oligometastatic disease: outcome of the UZ Gent patient population.
Vanacker Isabeau, 2025
Popularizing summary
One of the possible treatments for cancer, is radiation therapy. Previously, patients got smaller
doses in more visits, because this seemed to be better in minimizing side effects. Imaging and
radiation techniques, among others, improved over the years and the interest in higher doses
in less visits grew. This decreases the patients practical burden by decreasing the number of
visits and increases disease control of the irradiated lesion in the same time. An interesting use
of the these high doses is treating disseminated lesions in patients with only a few lesions. For
these patients, also called oligometastatic patients, a great interest in curative treatments is
nowadays investigated. The few lesions form multiple targets for treatment, which requires
accurate radiation therapy for avoiding adverse events caused by irradiation on neighbouring
organs. For this treatment, we need to be able to select those patients who would benefit from
radiation therapy on the disseminated lesions. A suggested classification system distinguishes
patients with a history of multiple disseminated lesions that were partially controlled by
chemotherapy or another sort of systemic therapy, patients who have a history of a few lesions
and patients who did not have disseminated lesions, but now do. There are also patients who
already had disseminated lesions at the first diagnosis of cancer. Another distinction that can
be made in the former mentioned three categories is whether the disseminated lesions were
growing while under some sort of systemic therapy or not, or whether they remain more present
than other lesions. For this thesis, oligometastatic patients receiving radiation therapy on
disseminated lung, abdominal lymph node and adrenal lesions were gathered from a list and
information was collected from patient files. The results of the overall selected patient
population conformed approximately to existing literature, confirming the curative potential of
highly dosed radiotherapy in oligometastatic patietns. After performing statistics, the results
pointed in the direction of a better survival of patients who did not have lesions in their history,
compared to patients who had multiple lesions in their history and patients with lesions which
grew under systemic therapy had a less favourable survival. Patients with disseminated lesions
at first cancer diagnosis had a relatively less favourable survival, but when surviving, the treated
lesions remained stable for longer. This classification can already distinguish different types of
patients, but the effects of other factors on survival and other patient outcomes are still to be
investigated more. This thesis attempted to study the effect of lesion location, number of treated
lesions, number of treatments and dose. The only significant observation is the more favourable
survival of patients with abdominal lymph node compared to lung and adrenal lesions.
Social relevance
This thesis results can impact treatment decisions of clinicians about patients with only a few
disseminated lesions. More specifically, oligometastatic patients with a curative potential can
be selected for treatment and patients without a curative potential will not be bothered with
unnecessary treatments. The most important idea still is the curative potential for these
patients, when they were previously only treated with palliative purpose.
| Promotor | Yolande Lievens |
| Opleiding | Geneeskunde |
| Domein | Oncologie |
| Kernwoorden | radiotherapy, oligometastasis |