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Semin Respir Crit Care Med · Jun 2020
ReviewLocal Ablative Therapies in Oligometastatic NSCLC: New Data and New Directions.
- Pencilla Lang, Daniel R Gomez, and David A Palma.
- Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada.
- Semin Respir Crit Care Med. 2020 Jun 1; 41 (3): 369-376.
AbstractThe oligometastatic and oligoprogressive disease states have been recently recognized as common clinical scenarios in the management of non-small cell lung cancer (NSCLC). As a result, there has been increasing interest in treating these patients with locally ablative therapies including surgery, conventionally fractionated radiotherapy, stereotactic ablative radiotherapy, and radiofrequency ablation. This article provides an overview of oligometastatic and oligoprogressive disease in the setting of NSCLC and reviews the evidence supporting ablative treatment. Phase II randomized controlled trials and retrospective series suggest that ablative treatment of oligometastases may substantially improve progression-free survival and overall survival, and additional large randomized studies testing this hypothesis in a definitive context are ongoing. However, several challenges remain, including quantifying the possible benefits of ablative therapies for oligoprogressive disease and developing prognostic and predictive models to assist in clinical decision making.Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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