Superior outcomes of nodal metastases compared to visceral sites in oligometastatic colorectal cancer treated with stereotactic ablative radiotherapy

O’Cathail, Séan M.; Smith, Thomas P.; Owens, Robert; Zeniou, Anthi; Tsang, Yatman; Holyoake, D.; Murray, Louise; Harrison, Mark; Hawkins, M.

doi:10.1016/j.radonc.2020.08.012

Cited by 12 publications

(8 citation statements)

References 35 publications

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“…These implied that each SABR treatment site should have its own specific fractionation schedule and extra caution should be taken in terms of post-treatment toxicities with SABR treatments of high BED 10 . In agreement with O’Cathail et al, 25 the estimated median PFS of our whole cohort was 14.6 months and the multivariate Cox regression analysis suggested that CRC patients with nodal oligometastatic disease had better PFS compared to non-nodal oligometastatic disease (median 17.8 vs 10.8 months).…”

Section: Discussionsupporting

confidence: 92%

Treatment outcomes of stereotactic ablative body radiotherapy on oligometastases from colorectal cancer: early results of a single institution service evaluation

et al. 2022

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Objectives: Stereotactic ablative radiotherapy (SABR) has been suggested to be an effective non-invasive ablative therapy for oligometastases originated from colorectal cancer (CRC). This study aimed to report CRC oligometastases SABR treatment outcomes in terms of overall survival (OS), progression free survival (PFS) and post-treatment toxicities. Methods: Treatment records of patients with CRC metachronous oligometastases who underwent SABR at a single institution between February 2015 and December 2018 were retrospectively reviewed. OS and PFS were calculated using Kaplan-Meier statistics and post RT toxicity data was scored following CTCAEv4.0. Analysis of prognostic factors on OS and PFS was performed based on site of primary cancer, types of treatment to primary cancer, number of oligometastases, SABR treatment sites, intervals between treatment to primary cancer and SABR to oligometastases, biological equivalent dose, cumulative gross tumour volume and planning target volume. Results: 75 patients with 86 CRC metachronous oligometastases (including liver, lung, lymph nodes and bone) were included. The median age was 65.5 years (range 42.5–87.2) with a median follow-up of 23.8 months (range 3.1–46.5). The estimated median PFS was 14.6 months (95% CI 9.6–19.6). and estimated median OS was 33.3 months (95% CI 22.9–43.7). Majority of patients tolerated SABR well with the most common acute side-effects of Grade one fatigue. No Grade three or higher toxicities were reported at any time points. Only SABR treatment sites (p = 0.03) and cumulative volumes of planning target volume (p = 0.02) were found to be statistically significant independent predictors of PFS and OS respectively. Conclusions: This study showed modest PFS, OS, and post-treatment toxicity outcomes on SABR to metachronous oligometastases from CRC. It has highlighted that cumulative tumour volume may be a stronger prognostic factor of OS comparing to the number of metastases. Advances in knowledge: There is limited data published on the efficacy and post treatment toxicity of CRC oligometastases SABR with adequate length of follow up. Our retrospective study suggests that cumulative tumour volume may be a stronger prognostic factor of overall survival comparing to the number of oligometastases.

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Section: Discussionsupporting

confidence: 92%

Treatment outcomes of stereotactic ablative body radiotherapy on oligometastases from colorectal cancer: early results of a single institution service evaluation

et al. 2022

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“…The authors collected data from 96 patients with 108 lesions (48.1% abdominal/pelvic lymph nodes) undergoing MRgRT with a median BED α/β =10 of 100 Gy, reporting 1-year freedom from local progression (FFLP), freedom from distant progression (FFDP), and PFS and OS rates of 92.3%, 41.1%, and 39.3% e 89.6%, respectively. Although these results seem to be similar to ours, the local and global disease control outcomes differ from those reported in our study, as the authors also included lymph node metastases, which are known to have a higher response to SBRT, compared to parenchymal metastases [ 29 ].…”

Section: Discussionsupporting

confidence: 79%

Magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) for oligometastatic patients: a single-center experience

et al. 2023

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Purpose Stereotactic body radiotherapy is increasingly used for the treatment of oligometastatic disease. Magnetic resonance-guided stereotactic radiotherapy (MRgSBRT) offers the opportunity to perform dose escalation protocols while reducing the unnecessary irradiation of the surrounding organs at risk. The aim of this retrospective, monoinstitutional study is to evaluate the feasibility and clinical benefit (CB) of MRgSBRT in the setting of oligometastatic patients. Materials and methods Data from oligometastatic patients treated with MRgSBRT were collected. The primary objectives were to define the 12-month progression-free survival (PFS) and local progression-free survival (LPFS) and 24-month overall survival (OS) rate. The objective response rate (ORR) included complete response (CR) and partial response (PR). CB was defined as the achievement of ORR and stable disease (SD). Toxicities were also assessed according to the CTCAE version 5.0 scale. Results From February 2017 to March 2021, 59 consecutive patients with a total of 80 lesions were treated by MRgSBRT on a 0.35 T hybrid unit. CR and PR as well as SD were observed in 30 (37.5%), 7 (8.75%), and 17 (21.25%) lesions, respectively. Furthermore, CB was evaluated at a rate of 67.5% with an ORR of 46.25%. Median follow-up time was 14 months (range: 3–46 months). The 12-month LPFS and PFS rates were 70% and 23%, while 24-month OS rate was 93%. No acute toxicity was reported, whereas late pulmonary fibrosis G 1 was observed in 9 patients (15.25%). Conclusion MRgSBRT was well tolerated by patients with reported low toxicity levels and a satisfying CB. Supplementary Information The online version contains supplementary material available at 10.1007/s11547-023-01627-4.

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“…A prospective cohort was published in this oligo metastatic setting with superior outcomes for lymph node involvement versus visceral involvement (hepatic and lung metastases mainly). In this series, local control at 1 year was 90% for lymph node irradiation versus 75% for visceral lesions [8].…”

Section: Discussionmentioning

confidence: 62%

Prolonged Remission After Radiotherapy in a Patient with BRAF V600E Mutated Colon Cancer with Latero-Aortic Lymph Node Involvement

2022

Ann Case Report

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Superior outcomes of nodal metastases compared to visceral sites in oligometastatic colorectal cancer treated with stereotactic ablative radiotherapy

Cited by 12 publications

References 35 publications

Treatment outcomes of stereotactic ablative body radiotherapy on oligometastases from colorectal cancer: early results of a single institution service evaluation

Treatment outcomes of stereotactic ablative body radiotherapy on oligometastases from colorectal cancer: early results of a single institution service evaluation

Magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) for oligometastatic patients: a single-center experience

Prolonged Remission After Radiotherapy in a Patient with BRAF V600E Mutated Colon Cancer with Latero-Aortic Lymph Node Involvement

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