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Semin Respir Crit Care Med 2020; 41(03): 369-376
DOI: 10.1055/s-0039-3400290
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Local Ablative Therapies in Oligometastatic NSCLC: New Data and New Directions

Pencilla Lang
1   Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada
,
Daniel R. Gomez
2   Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
,
David A. Palma
1   Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada
› Author Affiliations
Further Information

Publication History

Publication Date:
25 May 2020 (online)

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Abstract

The 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.

Keywords

NSCLC - SABR - local consolidative therapy - oligometastasis - oligoprogression
 

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