Stereotactic body radiation therapy for oligometastatic pulmonary tumors from cervical cancer

Objective To evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) for oligometastatic pulmonary tumors from cervical cancer. Methods A total of 29 oligometastatic pulmonary lesions from cervical cancer in 19 patients were treated with SBRT in our institute from 2011 to 2016. Thirteen patients (68.4%) suffered with solitary lung metastasis, three patients (15.8%) with multiple unilateral lesions and three patients (15.8%) with bilateral lesions. The median size of lung lesions was 2 cm (0.7-5.6 cm). Patients underwent cone-beam CT before the delivery of SBRT. The most common dose fractionation schemes were 64 Gy in eight fractions (eight lesions) and 56 Gy in seven fractions (seven lesions). Nine patients (47.4%) received systemic chemotherapy. Results The median follow-up was 9.5 months (3.0-62.4 months). The one-year overall survival (OS), progression-free survival (PFS) and local control (LC) rates were 76.8%, 55.8% and 75.6%, respectively. The median PFS was 12.7 months. Six patients (31.6%) gained more than 20 months disease-free survival. Eleven patients (57.9%) experienced tumor relapse, including seven patients with pulmonary relapse and four patients with extra-pulmonary disease. Only one patient (5.3%) experienced symptomatic radiation pneumonitis (grade 2). Conclusion SBRT was an efficacy and safe approach for patients with oligometastatic pulmonary tumor from cervical cancer. SBRT should be considered as a potential alternative to resection for these patients.