Multi-institutional analysis of extracranial oligometastatic colorectal cancer patients treated with stereotactic body radiation therapy: TROD 02-008 study

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发表日期：

2024年8月19日

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Ozan Cem Guler,
Pervin Hurmuz,
Banu Atalar,
Yıldız Guney,
Esra Kaytan Saglam,
Serap Akyurek,
Yasemin Bolukbasi,
Zeynep Gural,
Fuzuli Tugrul,
Aylin Korcum,
Cenk Ahmet Sen,
Berna Akkus Yildirim,
Didem Colpan Oksuz,
Meral Kurt,
Zeliha Guzeloz,
Gorkem Aksu,
Mert Saynak,
Gamze Aksu,
Cem Onal

摘要

Purpose

To investigate the treatment outcomes of extracranial oligometastatic colorectal cancer (CRC) patients treated with stereotactic body radiotherapy (SBRT).

Materials and methods

The clinical data of 388 extra-cranial oligometastatic CRC (≤ 5 lesions) patients and 463 lesions treated with SBRT at 19 cancer institutions were retrospectively analyzed. The prognostic factors predicting overall survival (OS), progression-free survival (PFS), and local control (LC) were assessed in uni- and multivariable analyses.

Results

The median age was 62 years (range, 29–92 years). The majority of the patients (90.5%) received surgery and systemic treatment for their primary tumor, had ≤ 2 metastasis (83.3%), had single organ involvement (90.3%), and staged using flouro-deoxyglucose positron emission tomography (FDG-PET/CT) (76%). The median fraction and total radiation doses were 10 Gy (range: 6–34 Gy) and 50 Gy (range: 8–64 Gy), respectively, delivered in a median of 4 fractions (range: 1–8). The median follow-up time for the entire cohort was 30.7 months (interquartile range: 27.0–34.3 months). The 3‑year OS, PFS, and LC rates were 64.0%, 42.3%, and 72.7%, respectively. The 3‑year LC rate was significantly higher in patients receiving BED₁₀ ≥ 100 Gy than those receiving BED₁₀ < 100 Gy (76.0% vs. 67.3%; p = 0.04). The 3‑year PFS and OS rates were higher in patients receiving BED₁₀ ≥ 100 Gy than those receiving BED₁₀ < 100 Gy (33.2% vs. 25.2%; p = 0.03; 53.7% vs. 44.8%; p = 0.02). Single metastasis and complete response after SBRT were independent prognostic factors for survival in multivariable analysis.

Conclusions

In this multi-center study, we demonstrated that SBRT is an effective treatment option of metastatic lesions in oligometastatic CRC patients by providing promising LC rates. Higher SBRT doses beyond BED₁₀ ≥ 100 Gy were associated with improved LC and survival. LC of treated lesion and lower tumor burden after SBRT were associated with better outcomes.