Andrea Riccardo Filippi1, Serena Badellino2, Manuela Ceccarelli3, Alessia Guarneri4, Pierfrancesco Franco2, Chiara Monagheddu3, Rosella Spadi5, Riccardo Ragona2, Patrizia Racca5, Umberto Ricardi2. 1. Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy. Electronic address: andreariccardo.filippi@unito.it. 2. Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy. 3. Cancer Epidemiology and CPO Piemonte, Città della Salute e della Scienza, Torino, Italy. 4. Radiation Oncology, Città della Salute e della Scienza, Torino, Italy. 5. Medical Oncology, Colorectal Cancer Unit, Città della Salute e della Scienza, Torino, Italy.
Abstract
PURPOSE: To estimate stereotactic ablative radiation therapy (SABR) efficacy and its potential role as an alternative to surgery for the treatment of lung metastases from colorectal cancer. METHODS AND MATERIALS: Forty consecutive patients who received SABR as first local therapy at the time of lung progression were included, from 2004 to 2014. The primary study endpoint was overall survival. Secondary endpoints were progression-free survival and safety. RESULTS: A single nodule was treated in 26 patients (65%), 2 nodules in 10 patients (25%), 3 in 3 patients (7.5%), and 4 in 1 patient (2.5%), for a total of 59 lesions. The median delivered biological effective dose was 96 Gy, in 1 to 8 daily fractions. Median follow-up time was 20 months (range, 3-72 months). Overall survival rates at 1, 2, and 5 years were, respectively, 84%, 73%, and 39%, with 14 patients (35%) dead. Median overall survival was 46 months. Progression occurred in 25 patients (62.5%), at a median interval of 8 months; failure at SABR site was observed in 3 patients (7.5%). Progression-free survival rates were 49% and 27% at 1 and 2 years, respectively. DISCUSSION: The results of this retrospective exploratory analysis suggest safety and efficacy of SABR in patients affected with colorectal cancer lung oligometastases and urge inclusion of SABR in prospective clinical trials.
PURPOSE: To estimate stereotactic ablative radiation therapy (SABR) efficacy and its potential role as an alternative to surgery for the treatment of lung metastases from colorectal cancer. METHODS AND MATERIALS: Forty consecutive patients who received SABR as first local therapy at the time of lung progression were included, from 2004 to 2014. The primary study endpoint was overall survival. Secondary endpoints were progression-free survival and safety. RESULTS: A single nodule was treated in 26 patients (65%), 2 nodules in 10 patients (25%), 3 in 3 patients (7.5%), and 4 in 1 patient (2.5%), for a total of 59 lesions. The median delivered biological effective dose was 96 Gy, in 1 to 8 daily fractions. Median follow-up time was 20 months (range, 3-72 months). Overall survival rates at 1, 2, and 5 years were, respectively, 84%, 73%, and 39%, with 14 patients (35%) dead. Median overall survival was 46 months. Progression occurred in 25 patients (62.5%), at a median interval of 8 months; failure at SABR site was observed in 3 patients (7.5%). Progression-free survival rates were 49% and 27% at 1 and 2 years, respectively. DISCUSSION: The results of this retrospective exploratory analysis suggest safety and efficacy of SABR in patients affected with colorectal cancer lung oligometastases and urge inclusion of SABR in prospective clinical trials.
Authors: Alina Mihai; Yijia Mu; John Armstrong; Mary Dunne; Sushil Beriwal; Luke Rock; Pierre Thirion; Dwight E Heron; Brian Healy Bird; Jennifer Westrup; Conleth Gerard Murphy; M Saiful Huq; Raymond McDermott Journal: J Radiosurg SBRT Date: 2017