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Lung Cancer Diagnosis and Treatment / Management of Metastatic Bone Disease / Advanced Radiotherapy Techniques · Journal article
Journal of Clinical Medicine · August 16, 2026
Early or partial results. Treat as a signal, not a conclusion.
This retrospective single-center study reports that moderate-dose SBRT (BED10 25–100 Gy) achieved 98.2% objective response and 89.7% 1-year local recurrence-free survival in 43 oligometastatic lung cancer patients deemed unfit for standard ablative SBRT. Toxicity was low (18.6% grade 1–2; no grade ≥3), supporting feasibility of a risk-adapted approach, but the preliminary design and lack of comparative data limit definitive conclusions.
Retrospective single-center cohort study. Patients with pathologically confirmed lung cancer and extracranial oligometastasis deemed unfit for standard ablative SBRT; mean age 66 years; lymph node metastases most frequent site (69.1%); brain and bone metastases excluded.. Intervention: Moderate-dose stereotactic body radiation therapy (SBRT) with BED10 below 100 Gy but exceeding conventional palliative doses, delivered as 25–40 Gy in 4–7 fractions (most common: 35 Gy in 5 fractions, 63.6%). n = 43. Single institution (not named).
Objective response (complete or partial) achieved in 54 of 55 lesions (98.2%) 1-year and 2-year local recurrence-free survival rates were 89.7% and 86.9%, respectively 1-year and 2-year overall survival rates were 83.2% and 56.1%, respectively
Treatment-related toxicities in 8 of 43 patients (18.6%), all grade 1–2; no grade ≥3 events
This study supports consideration of moderate-dose SBRT as a risk-adapted alternative in oligometastatic lung cancer patients with contraindications to standard ablative doses. However, the retrospective single-center design and modest sample warrant prospective validation before practice adoption, particularly given site-dependent variation in local control (95.5% vs 56.2%).
Single-center retrospective study of moderate-dose SBRT in a selected population unfit for standard therapy; favorable local control and safety observed but limited by retrospective design, single institution, and modest sample size requiring confirmation.
As stated by the source record.
Quoted from the source exactly as published.
This study supports consideration of moderate-dose SBRT as a risk-adapted alternative in oligometastatic lung cancer patients with contraindications to standard ablative doses. However, the retrospective single-center design and modest sample warrant prospective validation before practice adoption, particularly given site-dependent variation in local control (95.5% vs 56.2%).
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background/Objectives: Stereotactic body radiation therapy (SBRT) is increasingly used for oligometastatic lung cancer. However, standard ablative SBRT (BED10 of 100 Gy or higher) is not feasible when lesions abut critical organs or patients have poor performance status. This study aimed to evaluate the efficacy and safety of moderate-dose SBRT (BED10 below 100 Gy but exceeding conventional palliative doses) in patients with oligometastatic lung cancer unfit for standard ablative SBRT. Methods: We retrospectively analyzed patients treated at a single institution between October 2019 and March 2025. Eligible patients had pathologically confirmed lung cancer with extracranial oligometastasis and received 25–40 Gy in 4–7 fractions. Patients with brain or bone metastases were excluded. The primary endpoint was local control. Secondary endpoints were event-free survival, disseminated disease-free survival, overall survival, and treatment-related toxicity. Results: Forty-three patients with 55 lesions were analyzed. The mean age was 66 years, and lymph node metastases were the most frequent site (69.1%). The most common regimen was 35 Gy in 5 fractions (63.6%). At a median follow-up of 14.7 months, objective response (complete or partial) was achieved in 54 of 55 lesions (98.2%). The 1-year and 2-year local recurrence-free survival rates were 89.7% and 86.9%, respectively, and the 1-year and 2-year overall survival rates were 83.2% and 56.1%, respectively. Local control differed by metastatic site, with 2-year rates of 95.5% for lymph node lesions and 56.2% for lesions of the lung and chest wall (p = 0.002), whereas smaller differences were observed by BED10 and oligometastatic subtype. Treatment-related toxicities occurred in 8 of 43 patients (18.6%), all of grade 1–2, and radiation pneumonitis was the most common (9.3%). No grade 3 or higher events occurred. Conclusions: In this preliminary single-center experience, moderate-dose SBRT achieved favorable local control with acceptable toxicity in oligometastatic lung cancer patients unfit for standard ablative SBRT, supporting a risk-adapted approach.
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