Stereotactic body radiotherapy as a viable treatment on extracranial oligometastases in melanoma patients: a retrospective multicentric study

Victorine Trentesaux; Sophie Maiezza; Emilie Bogart; Marie-Cécile Le Deley; Emmanuel Meyer; Ludovic Vanquin; David Pasquier; Laurent Mortier; Xavier Mirabel

doi:10.3389/fonc.2024.1322515

Stereotactic body radiotherapy as a viable treatment on extracranial oligometastases in melanoma patients: a retrospective multicentric study

Front Oncol. 2024 Mar 5:14:1322515. doi: 10.3389/fonc.2024.1322515. eCollection 2024.

Authors

Affiliations

¹ Academic Department of Radiation Oncology, Centre Oscar Lambret, Lille, France.
² Department of Dermatology, Hôpital Claude Huriez du Centre hospitalo-universitaire (CHU) de Lille, Lille, France.
³ Clinical Research and Innovation Department, Centre Oscar Lambret, Lille, France.
⁴ Department of Radiotherapy, Centre Francois Baclesse, Caen, France.
⁵ Department of Medical Physics, Centre Oscar Lambret, Lille, France.
⁶ Centre de Recherche en Informatique, Signal et Automatique de Lille (CRIStAL), Centre national de recherche scientifique (CNRS-UMR) 9189, University of Lille, Lille, France.
⁷ Department of Medicine, University of Lille, Lille, France.

Abstract

Introduction: Stereotactic radiotherapy (SBRT) potentially has a role in the management of oligometastatic melanoma. However, literature with data specific to this management is very limited. The objectives of this study were to evaluate the time to local control (LC) of extra-cranial melanoma metastases after SBRT treatment and to help establish if SBRT is a useful therapy for oligometastatic melanoma.

Methods: A retrospective study was conducted with data collected from two referral centers in France between 2007 and 2020. The oligometastatic status of patients was reported based on the latest recommendations with a maximum of three lesions prior to treatment.

Results: A total of 69 patients receiving SBRT for 88 oligometastatic melanoma metastases were included. The median follow-up time was 42.6 months. Most patients were treated for metachronous oligometastatic lesions. Occurrence of oligoprogression, oligorecurrence, and oligopersistence was reported in 42.0%, 39.1%, and 17.4% of cases, respectively. Treated lesions were mostly pulmonary (40.6%), followed by lymph node (34.8%) and hepatic sites (24.6%). Progression-free survival at 1, 2, and 3 years were 47.0% (35-59), 27.0% (16-39), and 25.0% (15.0-37.0), respectively. Time to LC rates at 1, 2, and 3 years were 94.2% (87.0-98.1), 90.3% (81.3-96.1), and 90.3% (81.3-96.1), respectively. Overall survival at 1, 2, and 3 years were 87% (76.0-93.0), 74.0% (76.0-93.0), and 61.0% (47.0-73.0), respectively. Only 17.4% of patients experienced acute, grade 1 or grade 2 toxicities with no reports of grade 3 or higher toxicities.

Conclusion: SBRT demonstrated efficacy in managing melanoma patients with extracranial oligometastases and showed an overall low toxicity profile. Future randomized studies are needed to establish the role of SBRT in therapeutic approaches for patients with oligometastatic melanoma.

Keywords: CyberKnife; SBRT; extracranial oligometastases; melanoma; stereotactic body radiotherapy.

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article. No specific grant from any funding agency in the public, commercial, or not-forprofit sectors was received for this study.