TY - JOUR
T1 - Stereotactic Ablative Radiotherapy (SABR) in inoperable oligometastatic disease from colorectal cancer
T2 - A safe and effective approach
AU - Comito, Tiziana
AU - Cozzi, Luca
AU - Clerici, Elena
AU - Campisi, Maria C.
AU - Liardo, Rocco Luca E
AU - Navarria, Pierina
AU - Ascolese, AnnaMaria
AU - Tozzi, Angelo
AU - Iftode, Cristina
AU - De Rose, Fiorenza
AU - Villa, Elisa
AU - Personeni, Nicola
AU - Rimassa, Lorenza
AU - Santoro, Armando
AU - Fogliata, Antonella
AU - Mancosu, Pietro
AU - Tomatis, Stefano
AU - Scorsetti, Marta
PY - 2014/7/27
Y1 - 2014/7/27
N2 - Background: To assess the safety and efficacy of Stereotactic Ablative Radiotherapy (SABR) in oligometastatic patients from colorectal cancer.Methods: 82 patients with 1-3 inoperable metastases confined to one organ (liver or lung), were treated with SABR for a total of 112 lesions in an observational study. Prescription dose ranged between 48 and 75Gy in 3 or 4 consecutive fractions. Primary end-points were local control (LC), overall survival (OS) and progression-free survival (PFS). Secondary end-point was toxicity.Results: Median follow-up was 24 months (range 3-47). One, two and three years LC rate was 90%,80% and 75% (85%,75% and 70% for lung and 95%, 90% and 85% for liver metastases; no statistically significance was found). The difference in LC between the subgroup of lesions treated with ≥60 Gy (n = 58) and those irradiated with <60 Gy (n = 52) was statistically significant, with a 1, 2 and 3 yrs LC of 97%,92% and 83% for the higher dose, compared to 85%,70% and 70% for the lower dose (p < 0.04). Median OS was 32 months. Actuarial OS rate at 1, 2 and 3 yrs was 85%,65% and 43%. Univariate analysis showed a correlation only between OS and cumulative GTV > 3 cm (p < 0.02). Median PFS was 14 months, with a PFS rate of 56% at 1 yr and 40% at 2-3 yrs, without correlation with the site and prescription dose (p < 0.48 and p < 0.56). No patients experienced radiation-induced liver disease or grade >3 toxicity.Conclusions: SABR is a safe and feasible alternative treatment of oligometastatic colorectal liver and lung metastases in patients not amenable to surgery or other ablative treatments.
AB - Background: To assess the safety and efficacy of Stereotactic Ablative Radiotherapy (SABR) in oligometastatic patients from colorectal cancer.Methods: 82 patients with 1-3 inoperable metastases confined to one organ (liver or lung), were treated with SABR for a total of 112 lesions in an observational study. Prescription dose ranged between 48 and 75Gy in 3 or 4 consecutive fractions. Primary end-points were local control (LC), overall survival (OS) and progression-free survival (PFS). Secondary end-point was toxicity.Results: Median follow-up was 24 months (range 3-47). One, two and three years LC rate was 90%,80% and 75% (85%,75% and 70% for lung and 95%, 90% and 85% for liver metastases; no statistically significance was found). The difference in LC between the subgroup of lesions treated with ≥60 Gy (n = 58) and those irradiated with <60 Gy (n = 52) was statistically significant, with a 1, 2 and 3 yrs LC of 97%,92% and 83% for the higher dose, compared to 85%,70% and 70% for the lower dose (p < 0.04). Median OS was 32 months. Actuarial OS rate at 1, 2 and 3 yrs was 85%,65% and 43%. Univariate analysis showed a correlation only between OS and cumulative GTV > 3 cm (p < 0.02). Median PFS was 14 months, with a PFS rate of 56% at 1 yr and 40% at 2-3 yrs, without correlation with the site and prescription dose (p < 0.48 and p < 0.56). No patients experienced radiation-induced liver disease or grade >3 toxicity.Conclusions: SABR is a safe and feasible alternative treatment of oligometastatic colorectal liver and lung metastases in patients not amenable to surgery or other ablative treatments.
KW - Colorectal oligometastases
KW - Liver
KW - Lung
KW - RapidArc
KW - Stereotactic ablative radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=84907011514&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84907011514&partnerID=8YFLogxK
U2 - 10.1186/1471-2407-14-619
DO - 10.1186/1471-2407-14-619
M3 - Article
C2 - 25163798
AN - SCOPUS:84907011514
VL - 14
JO - BMC Cancer
JF - BMC Cancer
SN - 1471-2407
IS - 1
M1 - 619
ER -