Stereotactic Ablative Radiation Therapy for Colorectal Liver Metastases.
| Autor: | McDermott RL; Department of Radiation Oncology, British Columbia Cancer Agency - Vancouver Centre, Vancouver, British Columbia, Canada. Electronic address: ronan.mcdermott@bccancer.bc.ca., Dunne EM; Department of Radiation Oncology, British Columbia Cancer Agency - Vancouver Centre, Vancouver, British Columbia, Canada., Zhao Y; Department of Radiation Oncology, British Columbia Cancer Agency - Surrey Centre, Surrey, British Columbia, Canada., Bergman A; Department of Medical Physics, British Columbia Cancer Agency - Vancouver Centre, Vancouver, British Columbia, Canada., Liu MC; Department of Radiation Oncology, British Columbia Cancer Agency - Vancouver Centre, Vancouver, British Columbia, Canada., Schellenberg D; Department of Radiation Oncology, British Columbia Cancer Agency - Surrey Centre, Surrey, British Columbia, Canada., Ma RM; Department of Radiation Oncology, British Columbia Cancer Agency - Vancouver Centre, Vancouver, British Columbia, Canada. |
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| Jazyk: | angličtina |
| Zdroj: | Clinical colorectal cancer [Clin Colorectal Cancer] 2023 Mar; Vol. 22 (1), pp. 120-128. Date of Electronic Publication: 2022 Nov 11. |
| DOI: | 10.1016/j.clcc.2022.10.006 |
| Abstrakt: | Introduction: Stereotactic Ablative Radiation Therapy (SABR) is a therapeutic option for patients with inoperable oligometastatic colorectal carcinoma (CRC). Given the scarcity of prospective data on outcomes of SABR for metastatic CRC, this study aims to review SABR outcomes and determine predictive factors of local control (LC) and survival in patients with liver metastases from CRC. Materials and Methods: A retrospective review of SABR for CRC liver metastases between 2011 and 2019 was undertaken. Endpoints included LC, overall survival (OS), progression-free survival (PFS) and time to restarting systemic therapy. Univariate (UVA) and multivariable analyses (MVA) were performed to identify predictive factors. Results: Forty-eight patients were identified. The total number of tumors treated was 58. Median follow-up was 26.6 months. LC at 1, 2 and 3 years was 92.7%, 80.0%, and 61.2% respectively. Median time to local failure was 40.0 months (95% CI 31.8-76.1 months). Median OS was 31.9 months (95% CI 20.6-40.0 months). OS at 1, 2, and 3 years was 79.2%, 61.7%, and 44.9% respectively. Thirty-three patients (69%) restarted systemic therapy after completion of SABR. Median time to restarting chemotherapy was 11.0 months (95% CI 7.1-17.6 months). Systemic therapy free survival at 1, 2, and 3 years was 45.7%, 29.6%, and 22.6% respectively. On MVA, inferior LC was influenced by GTV volume ≥40 cm 3 (HR: 3.805, 95% CI 1.376-10.521, P = .01) and PTV D100% BED <100 Gy Conclusion: SABR is an effective therapeutic option for selected patients with CRC liver metastases providing acceptable LC within the first 2 years. In many cases, it provides meaningful chemotherapy-free intervals. Higher biological effective doses are required to enhance LC. Competing Interests: Disclosure None (Copyright © 2022 Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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