The Dandelion Dilemma Revisited for Oligoprogression: Treat the Whole Lawn or Weed Selectively?
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Date
2019-12-01ICR Author
Author
Patel, PH
Palma, D
McDonald, F
Tree, AC
Type
Journal Article
Metadata
Show full item recordAbstract
Oligoprogressive disease is a relatively new clinical concept describing progression at only a few sites of metastasis in patients with otherwise controlled widespread disease. In the era of well-tolerated targeted treatments, resistance inevitably occurs and overcoming this is a challenge. Local ablative therapy for oligoprogressive disease may allow the continuation of systemic treatments by overcoming the few sub-clones that have developed resistance. Stereotactic body radiotherapy is now frequently used in treating oligometastatic disease using ablative doses with minimally invasive techniques and acceptable toxicity. We discuss the current retrospective clinical evidence base supporting the use of local ablative therapy for oligoprogression in metastatic patients on targeted treatments within multiple tumour sites. As there is currently a lack of published prospective data available, the best management for these patients remains unclear. We discuss current trials in recruitment and the potential advancements in treating this group of patients with stereotactic radiotherapy.
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Subject
Humans
Neoplasms
Disease Progression
Radiosurgery
Retrospective Studies
Prospective Studies
Language
eng
Date accepted
2019-04-17
License start date
2019-12
Citation
Clinical oncology (Royal College of Radiologists (Great Britain)), 2019, 31 (12), pp. 824 - 833
Publisher
ELSEVIER SCIENCE LONDON