Siva et al Retrospective cohort Patients with 1–3 lung metastases, ≤ 50 mm, Intervention: Single-fraction SBRT Overall survival: time from SBRT to death (2015) extrathoracic disease treated definitively (calculated with Kaplan-Meier method) Level III-2 18 GY in 1 fraction (n = 1/40, 2%) Australia N = 41 (49 lesions) [intervention] Local control: failure defined as the Risk of bias: Moderate 26 GY in 1 fraction (n = 39/40, 98%) combination of a CT demonstrable serially N = 24 (33 lesions) [comparator] Median 25 months enlarging mass as per RECIST criteria, with the Size NR Comparator: Multi-fraction SBRT absence of air bronchograms and FDG avidity Males 24 (59%): Females 17 (41%) [intervention] 48 GY in 4 fractions (n = 14/24, 58%) on PET scanning Males 14 (58%): Females 10 (42%) [comparator] 49 GY in 7 fractions (n = 1/24, 4%) Adverse events: CTCAE v4.0 Median age 70 (IQR 64–79) years [intervention] 50 GY in 5 fractions (n = 9/24, 38%) Median age 67 (IQR 51–76) years [comparator] Prior therapy [all patients]: 23 (40%) had prior pulmonary metastasectomy before SBRT. 13 (20%) had systemic chemotherapy for metastatic disease before SBRT. Of these, 2/13 had two lines of chemotherapy, whereas the remaining 11/13 patients had a single line of chemotherapy. Primary cancer [intervention]: colorectal 10/41 (24%), lung 16/41 (39%), bone and soft tissue 4/41 (10%), other 12/41 (29%)* Primary cancer [comparator]: colorectal 10 (43%), head and neck 7 (30%), other 6 (26%)
Siva et al (2015) Australia Retrospective cohort Level III-2 Risk of bias: Moderate Median 25 months Patients with 1–3 lung metastases, ≤ 50 mm, extrathoracic disease treated definitively N = 41 (49 lesions) [intervention] N = 24 (33 lesions) [comparator] Size NR Males 24 (59%): Females 17 (41%) [intervention] Males 14 (58%): Females 10 (42%) [comparator] Median age 70 (IQR 64–79) years [intervention] Median age 67 (IQR 51–76) years [comparator] Prior therapy [all patients]: 23 (40%) had prior pulmonary metastasectomy before SBRT. 13 (20%) had systemic chemotherapy for metastatic disease before SBRT. Of these, 2/13 had two lines of chemotherapy, whereas the remaining 11/13 patients had a single line of chemotherapy. Primary cancer [intervention]: colorectal 10/41 (24%), lung 16/41 (39%), bone and soft tissue 4/41 (10%), other 12/41 (29%)* Primary cancer [comparator]: colorectal 10 (43%), head and neck 7 (30%), other 6 (26%) Intervention: Single-fraction SBRT 18 GY in 1 fraction (n = 1/40, 2%) 26 GY in 1 fraction (n = 39/40, 98%) Comparator: Multi-fraction SBRT 48 GY in 4 fractions (n = 14/24, 58%) 49 GY in 7 fractions (n = 1/24, 4%) 50 GY in 5 fractions (n = 9/24, 38%) Overall survival: time from SBRT to death (calculated with Kaplan-Meier method) Local control: failure defined as the combination of a CT demonstrable serially enlarging mass as per RECIST criteria, with the absence of air bronchograms and FDG avidity on PET scanning Adverse events: CTCAE v4.0
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