{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T23:45:14Z","timestamp":1789256714085,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T00:00:00Z","timestamp":1748131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute for Health Research (NIHR) Biomedical Research Centre"},{"name":"Institute of Cancer Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Stereotactic radiotherapy (SBRT) and radiofrequency ablation (RFA) are common ablative techniques for lung metastases. A retrospective review of all patients treated with either modality at a single institution between 2011 and 2019 was conducted. Baseline characteristics and outcomes were compared. Local and distant progression, and overall survival were estimated using the Kaplan\u2013Meier method. Univariable analysis was carried out using Cox regression; this was followed by multivariable modelling. In total, 106 patients treated with RFA and 70 treated with SBRT were identified. Tumours treated with SBRT were larger (median size 18 mm vs. 11 mm) and primarily oligometastatic (91.4% vs. 20%). Median progression-free survival (PFS) was 12.5 months for SBRT and 7.9 months for RFA (p = 0.009). Median OS was similar (p = 0.66). In multivariable analysis, lesion size &gt; 20 mm was predictive of adverse local PFS (p = 0.001), PFS (p = 0.0034) and OS (p = 0.001). A statistically significant interaction effect suggested that RFA was associated with better local PFS within colorectal primary patients (p = 0.035). This study highlights differences in patient selection and outcomes for RFA or SBRT in the treatment of lung metastases at our institution. Future studies for SBRT should focus on the optimum dose schedules required for different histologies. For less-radiosensitive tumours, RFA may offer a superior alternative where dose-escalated SBRT is not possible.<\/jats:p>","DOI":"10.3390\/curroncol32060303","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T20:26:50Z","timestamp":1748204810000},"page":"303","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ablative Techniques for Lung Metastases: Patient Selection and Outcomes Following Treatment with Stereotactic Radiotherapy or Radiofrequency Ablation"],"prefix":"10.3390","volume":"32","author":[{"given":"Jennifer W. S.","family":"Pang","sequence":"first","affiliation":[{"name":"Maidstone and Tunbridge Wells NHS Trust, Maidstone Hospital, Hermitage Lane, Maidstone ME16 9QQ, UK"},{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Tong","sequence":"additional","affiliation":[{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicos","family":"Fotiadis","sequence":"additional","affiliation":[{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Satchwell","sequence":"additional","affiliation":[{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zayn","family":"Rajan","sequence":"additional","affiliation":[{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Emarah","sequence":"additional","affiliation":[{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Taylor","sequence":"additional","affiliation":[{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman","family":"Bashir","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, Whitechapel Rd, London E1 1BB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6562-1033","authenticated-orcid":false,"given":"Derfel","family":"Ap Dafydd","sequence":"additional","affiliation":[{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"McCall","sequence":"additional","affiliation":[{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5158-1069","authenticated-orcid":false,"given":"David","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4990-2024","authenticated-orcid":false,"given":"Merina","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0022-5223(97)70397-0","article-title":"Long-Term Results of Lung Metastasectomy: Prognostic analyses based on 5206 cases","volume":"113","author":"Pastorino","year":"1997","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1186\/s13063-019-3837-y","article-title":"Pulmonary Metastasectomy versus Continued Active Monitoring in Colorectal Cancer (PulMiCC): A multicentre randomized clinical trial","volume":"20","author":"Treasure","year":"2019","journal-title":"Trials"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.radonc.2013.05.024","article-title":"Pulmonary oligometastases: Metastasectomy or stereotactic ablative radiotherapy?","volume":"107","author":"Widder","year":"2013","journal-title":"Radiother. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.clon.2016.02.001","article-title":"Exploratory Analysis on Overall Survival after Either Surgery or Stereotactic Radiotherapy for Lung Oligometastases from Colorectal Cancer","volume":"28","author":"Filippi","year":"2016","journal-title":"Clin. Oncol. (R. Coll. Radiol.)"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2830","DOI":"10.1200\/JCO.20.00818","article-title":"Stereotactic Radiotherapy for the comprehensive treatment of oligometastatic cancers: Long term results of the SABR-COMET phase II Randomised trial","volume":"38","author":"Palma","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1200\/JCO.19.00201","article-title":"Local Consolidative Therapy Vs. Maintenance Therapy or Observation for Patients With Oligometastatic Non-Small-Cell Lung Cancer: Long-Term Results of a Multi-Institutional, Phase II, Randomized Study","volume":"37","author":"Gomez","year":"2019","journal-title":"J. Clin. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1093\/annonc\/mdv037","article-title":"Radiofrequency ablation is a valid treatment option for lung metastases: Experience in 566 patients with 1037 metastases","volume":"26","author":"Deschamps","year":"2015","journal-title":"Ann. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.athoracsur.2008.12.061","article-title":"Radiofrequency Ablation for the Treatment of Pulmonary Metastases","volume":"87","author":"Pennathur","year":"2009","journal-title":"Ann. Thorac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1093\/annonc\/mdq098","article-title":"Long-term outcome of image-guided percutaneous radiofrequency ablation of lung metastases: An open-labeled prospective trial of 148 patients","volume":"21","author":"Chua","year":"2010","journal-title":"Ann. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5152\/dir.2015.14378","article-title":"Radiofrequency ablation for lung tumors: Outcomes, effects on survival, and prognostic factors","volume":"22","author":"Akhan","year":"2015","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1093\/icvts\/ivw089","article-title":"Long-term results of percutaneous radiofrequency ablation of pulmonary metastases: A single institution experience","volume":"23","author":"Fanucchi","year":"2016","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1007\/s00270-012-0500-3","article-title":"Survival after radiofrequency ablation in 122 patients with inoperable colorectal lung metastases","volume":"36","author":"Gillams","year":"2013","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1080\/02841860600908954","article-title":"Stereotactic Body Radiation Therapy (SBRT) for lung metastases","volume":"45","author":"Okunieff","year":"2006","journal-title":"Acta Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1080\/02841860600812685","article-title":"Clinical results of stereotactic body frame based fractionated radiation therapy for primary or metastatic thoracic tumors","volume":"45","author":"Yoon","year":"2006","journal-title":"Acta Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"454107","DOI":"10.1155\/2012\/454107","article-title":"Stereotactic Body Radiotherapy for Metastatic Lung Cancer as Oligo-Recurrence: An Analysis of 42 Cases","volume":"2012","author":"Takahashi","year":"2012","journal-title":"Pulm. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1200\/JCO.2008.19.6386","article-title":"Multi-Institutional Phase I\/II Trial of Stereotactic Body Radiation Therapy for Lung Metastases","volume":"27","author":"Rusthoven","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.ijrobp.2010.11.052","article-title":"Stereotactic body radiotherapy for pulmonary metastases from soft-tissue sarcomas: Excellent local lesion control and improved patient survival","volume":"82","author":"Dhakal","year":"2012","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.ijrobp.2008.01.002","article-title":"Stereotactic Body Radiotherapy for Oligometastatic Lung Tumors","volume":"72","author":"Norihisa","year":"2008","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.radonc.2011.05.033","article-title":"Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer","volume":"101","author":"Takeda","year":"2011","journal-title":"Radiother. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.lungcan.2011.04.021","article-title":"Stereotactic body radiation therapy for lung metastases","volume":"75","author":"Ricardi","year":"2011","journal-title":"Lung Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.radonc.2017.01.003","article-title":"Nomogram based overall survival prediction in stereotactic body radiotherapy for oligo-metastatic lung disease","volume":"123","author":"Rieber","year":"2017","journal-title":"Radiother. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1002\/jso.23548","article-title":"Radiofrequency ablation in metastatic melanoma","volume":"109","author":"Shashank","year":"2014","journal-title":"J. Surg. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"261","DOI":"10.2174\/1573405616999200819165709","article-title":"Non-surgical Treatments for Lung Metastases in Patients with Soft Tissue Sarcoma: Stereotactic Body Radiation Therapy (SBRT) and Radiofrequency Ablation (RFA)","volume":"17","author":"Tetta","year":"2021","journal-title":"Curr. Med. Imaging"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/S1470-2045(08)70155-4","article-title":"Response to radiofrequency ablation of pulmonary tumours: A prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study)","volume":"9","author":"Lencioni","year":"2008","journal-title":"Lancet Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.radonc.2013.06.047","article-title":"High-risk CT features for detection of local recurrence after stereotactic ablative radiotherapy for lung cancer","volume":"109","author":"Huang","year":"2013","journal-title":"Radiother. Oncol."},{"key":"ref_26","unstructured":"(2023, November 01). Clinical Commissioning Policy Stereotactic Ablative Radiotherapy (SABR) for Patients with Metachronous Extracranial Oligometastatic Cancer (All Ages) (URN: 1908) [200205P] NHS England. Available online: https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2020\/03\/1908-cc-policy-sbar-for-metachronous-extracranial-oligometastatic-cancer.pdf."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.ejmp.2017.12.020","article-title":"The impact of technology on the changing practice of lung SBRT","volume":"47","author":"Aznar","year":"2018","journal-title":"Physica Medica"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s13014-015-0340-9","article-title":"Outcomes of Stereotactic Body Radiotherapy (SBRT) treatment of multiple synchronous and recurrent lung nodules","volume":"10","author":"Owen","year":"2015","journal-title":"Radiat. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/j.ijrobp.2008.04.073","article-title":"Analysis of Patients With Oligometastases Undergoing Two or More Curative-Intent Stereotactic Radiotherapy Courses","volume":"73","author":"Milano","year":"2009","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Sumodhee, S., Bondiau, P.-Y., Poudenx, M., Cohen, C., Naghavi, A.O., Padovani, B., Maneval, D., Gal, J., Leysalle, A., and Ghalloussi, H. (2019). Long term efficacy and toxicity after stereotactic ablative reirradiation in locally relapsed stage III non-small cell lung cancer. BMC Cancer, 19.","DOI":"10.1186\/s12885-019-5542-3"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.radonc.2011.09.012","article-title":"Toxicity after reirradiation of pulmonary tumours with stereotactic body radiotherapy","volume":"101","author":"Peulen","year":"2011","journal-title":"Radiother. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/s13014-018-1041-y","article-title":"Re-irradiation in lung disease by SBRT: A retrospective, single institutional study","volume":"13","author":"Caivano","year":"2018","journal-title":"Radiat. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"5187","DOI":"10.21037\/jtd.2019.12.12","article-title":"A systematic review and meta analysis of stereotactic body radiation therapy for colorectal pulmonary metastases","volume":"11","author":"Cao","year":"2019","journal-title":"J. Thorac. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.radonc.2017.03.014","article-title":"Radiobiological parameters of liver and lung metastases derived from tumor control data of 3719 metastases","volume":"123","author":"Klement","year":"2017","journal-title":"Radiother. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1748-717X-6-34","article-title":"Stereotactic body radiation therapy for melanoma and renal cell carcinoma: Impact of single fraction equivalent dose on local control","volume":"6","author":"Stinauer","year":"2011","journal-title":"Radiat. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.semradonc.2022.11.007","article-title":"Radiotherapy for Lung Metastases: Conventional to Stereotactic Body Radiation Therapy","volume":"33","author":"Das","year":"2023","journal-title":"Semin. Radiat. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"4512","DOI":"10.21037\/jtd.2017.10.108","article-title":"Stereotactic body radiotherapy (SBRT) for pulmonary metastases from renal cell carcinoma-a multicenter analysis of the German working group \u201cStereotactic Radiotherapy\u201d","volume":"9","author":"Duma","year":"2017","journal-title":"J. Thorac. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2991","DOI":"10.21873\/invivo.12130","article-title":"Stereotactic Body Radiotherapy for Pulmonary Oligometastasis from Colorectal Cancer","volume":"34","author":"Kobayashi","year":"2020","journal-title":"Vivo"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e384","DOI":"10.1016\/j.clon.2023.03.008","article-title":"Stereotactic Body Radiation Therapy for Pulmonary Metastasis from Colorectal Adenocarcinoma: Biologically Effective Dose 150 Gy is Preferred for Tumour Control","volume":"35","author":"Lee","year":"2023","journal-title":"Clin. Oncol. (R. Coll. Radiol.)"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1038\/nrc1953","article-title":"Integration of EGFR inhibitors with radiochemotherapy","volume":"6","author":"Nyati","year":"2006","journal-title":"Nat. Rev. Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s11523-014-0342-9","article-title":"Panitumumab as a radiosensitizing agent in KRAS wild-type locally advanced rectal cancer","volume":"10","author":"Mardjuadi","year":"2015","journal-title":"Target. Oncol."},{"key":"ref_42","first-page":"4278","article-title":"The Ras Radiation Resistance Pathway 1","volume":"61","author":"Gupta","year":"2001","journal-title":"Cancer Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.biopha.2011.09.011","article-title":"Sorafenib sensitizes human colorectal carcinoma to radiation via suppression of NF-\u03baB expression in vitro and in vivo","volume":"66","author":"Kuo","year":"2012","journal-title":"Biomed. Pharmacother."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S0093-7754(03)00126-X","article-title":"Signaling inhibition with radiation in colorectal cancer: Clinical trials","volume":"30","author":"McKenna","year":"2003","journal-title":"Semin. Oncol."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/6\/303\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:40:00Z","timestamp":1760031600000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/6\/303"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,25]]},"references-count":44,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["curroncol32060303"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32060303","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,25]]}}}