방사선의학 웹진

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Abstract
Purpose: To evaluate outcomes and prognostic factors associated with metastasis-directed radiation therapy (MDRT) for oligometastatic endometrial cancer.

Methods and materials: We retrospectively analyzed 101 patients (203 lesions) with ≤5 metastatic lesions treated with MDRT between 2015 and 2025. Oligometastatic states were classified according to the European Society for Radiotherapy and Oncology-European Organisation for Research and Treatment of Cancer framework. Endpoints were overall survival (OS), progression-free survival (PFS), and local failure-free survival. Prognostic factors were assessed using multivariable Cox regression, and toxicities were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0.

Results: At a median follow-up of 36.4 months, 3-year OS, PFS, and 2-year local failure-free survival rates were 76.3%, 24.5%, and 64.7%, respectively. Multivariable analyses revealed that favorable oligometastatic disease classification, endometrioid histology, favorable radiation therapy (RT) response, and maximum dose ≥40 Gy (equivalent dose in 2 Gy fractions, α/β = 10) were independently associated with improved OS. All factors, except for histology, were significant for PFS. In a propensity-matched analysis, repeated MDRT for recurrent oligometastases showed a trend toward improved OS compared with a single course. One grade 3 event occurred with no grade ≥4 toxicity.

Conclusions: MDRT yielded favorable outcomes in oligometastatic endometrial cancer. Oligometastatic classification, histology, and RT response were major prognostic factors. MDRT may be a viable option within a multidisciplinary framework for de novo and recurrent oligometastases, but validation in prospective multicenter studies is warranted.

Affiliation

Won Hee Lee 1, Yong Bae Kim 1
1Department of Radiation Oncology, Yonsei Cancer Center & Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.