Outcomes of stereotactic body radiotherapy for bone oligometastases in older patients − A European multicenter cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Outcome patterns for stereotactic body radiotherapy (SBRT) of bone oligometastases (BoM) especially for older patients are inadequately defined. We aimed to evaluate oncological outcomes and tolerability of SBRT for BoM in older patients. MATERIAL AND METHODS: Patients ≥70 years treated with SBRT for BoM between 2010 and 2024 at 20 European centers were analyzed and compared to patients <70 years. Outcomes included local recurrence (LR)/ freedom from LR (FFLR), progression-free survival (PFS), overall survival (OS), and adverse events. RESULTS: 789 patients with 1079 BoM were analyzed. Median age was 68 years (range: 19-91), and 355 patients (45.0%) were ≥70 years. Most common primary tumors were prostate (57.4%), breast (13.8%), and lung cancers (10.5%). LR at 3 years was 9.3% (CI: 6.0-12.8%) in patients <70 years and 11.7% (CI: 7.1-16.8%) in patients ≥70 years (p = 0.39). Grade-3 adverse events occurred in 1.8% of patients <70 years and 1.4% ≥70 years. No grade-4/5 adverse events were observed. Fracture rates were 2.9% for patients <70 years, and 1.8% ≥70 years. A higher metastatic volume was associated with reduced FFLR (Hazard ratio [HR] 1.006; p = 0.02), PFS (HR 1.003; p = 0.05), and OS (HR 1.003; p = 0.04). A better performance status was related to improved PFS (HR 0.98; p < 0.01) and OS (HR 0.96; p < 0.001), while age was not a significant factor. CONCLUSION: This multicenter cohort analysis showed that SBRT of BoM is effective and well tolerated even in older patients. There were no significant differences in outcomes or side effects including fracture rates across patient age groups.
Source: Radiotherapy and Oncology
Authors: Franziska Nägler, Sebastian Schäfer, Isabell Seiler, Camilla von Wachter, Panagiotis Balermpas, Mauro Loi, Pierluigi Bonomo, Marek Slavik, Petr Burkon, Lena Kästner, Johannes Meents, Fabian Lohaus, Jochen Willner, Anna Sabrina Schunn, Sophia Drabke, Kenneth Klischies, Olaf Wittenstein, Priska Bank, Richard Partl, Jörg Andreas Müller, Ahmed Gawish, Arne Grün, Andrea Baehr, Maike Trommer, Eleni Gkika, Thomas Mader, Richard Holy, Bernd Frerker, Felix Ehret, Alexander Rühle, Matthias Guckenberger, Christos Moustakis, Thomas B. Brunner, Oliver Blanck, Judit Boda-Heggemann, Nils H. Nicolay
Institutions: University Hospital Leipzig, University of Zurich, University Hospital Zurich, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Masaryk University, Masaryk Memorial Cancer Institute, German Cancer Research Center, Heidelberg University, University Medical Centre Mannheim, Medizinische Fakultät Mannheim, Helmholtz-Zentrum Dresden-Rossendorf, OncoRay, University Hospital Carl Gustav Carus, Nationales Centrum für Tumorerkrankungen Dresden, Technische Universität Dresden, Bayreuth Medical Center, University Medical Center of the Johannes Gutenberg University Mainz, University Hospital Schleswig-Holstein, SRH Wald-Klinikum Gera, Medical University of Graz, University Hospital in Halle, Universitätsklinikum Gießen und Marburg, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, University Medical Center Hamburg-Eppendorf, University of Bonn, University Hospital Bonn, University Hospital Cologne, Kantonsspital Graubünden, Universitätsmedizin Rostock
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,770
Funder: Universität Leipzig
OpenAlex ID: W7135397520