Consolidative high‐dose thoracic radiotherapy for limited metastatic nonsmall cell lung cancer: Focusing on oligo‐progressive disease

Aim Prior clinical data have shown a significant survival benefit of consolidative local radiotherapy for patients with limited metastatic non‐small cell lung cancer (NSCLC). Therefore, this study aimed to evaluate the impact of consolidative high‐dose thoracic radiotherapy on local control rates and survivals in patients with limited metastatic NSCLC, especially focusing on oligo‐progressive disease. Methods We retrospectively reviewed the medical records of 45 patients with limited metastatic NSCLC who received consolidative high‐dose thoracic radiotherapy at the Korea University Guro Hospital between March 2015 and December 2020. In the current study, we included patients who showed partial response, stable disease, or oligo‐progressive disease on tumor response evaluation after systemic treatment. All patients underwent stereotactic body radiation therapy (23 patients) or intensity‐modulated radiation therapy (IMRT, 22 patients). Results The median follow‐up time was 42 months (range: 5–88 months). The overall 2‐year disease‐free survival (DFS) and overall survival (OS) rates were 80.7% and 88.4%, respectively. Among the 45 patients, only two patients treated with IMRT showed in‐field local recurrence. There was no local failure among the patients who showed oligo‐progressive disease after systemic treatment. In addition, the response to systemic treatment was not a significant factor for either DFS or OS rates (p = .471 and p = .414, respectively) in univariate analysis. Conclusions Consolidative high‐dose thoracic radiotherapy improves local control rates and helps achieve long‐term survival in patients with limited metastatic NSCLC. It is also effective and should be considered in patients with oligo‐progressive disease after systemic treatment. • There was no local failure among patients who showed oligo‐progressive disease at the thoracic site after systemic treatment. • Consolidative high‐dose thoracic radiotherapy improves local control rates and helps achieve long‐term survival in patients with limited metastatic NSCLC, and it is also effective and should be considered in patients with oligo‐progressive disease after systemic treatment.