Beini Chen, Justin Smith, Revadhi Chelvarajah, Alexandra Knesl, Parushka Moodley, David Pryor, Mark B Pinkham, G Tao Mai, Howard Y Liu, Yoo Young Lee
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There were 310 lesions treated with 53% located in the brain, 22% lung, 16% liver, 4% bone, 4% nodal and 1% other. Biologically effective dose (BED10) ranged from 33.6 to 151.2 Gy.LC was 75% (95% CI 67-81%) at 1 year and 65% (95%CI 56-73%) 2 years. On multivariable analysis (MVA), older age (HR 1.04, <i>p</i> = 0.001) and tumour volume >2.5 cc (HR 3.13, <i>p</i> < 0.001) were associated with worse LC.OS from first course of SBRT/SRS was 68% at 1 year (95%CI 58-76%), and 48% at 2 years (95%CI 38-58%). On MVA, ≥2 or more lines of systemic therapy (HR 3.04, <i>p</i> < 0.001) and brain metastases (HR 4.24, <i>p</i> = 0.001) were associated with shorter OS. Living long enough to receive ≥2 courses of SBRT/SRS (HR 0.20, <i>p</i> = 0.004) was associated with longer OS.</p><p><strong>Conclusion: </strong>This study demonstrates that SBRT and SRS offer effective local control, and LC is associated with tumour volume.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 3","pages":"237-243"},"PeriodicalIF":0.8000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136684/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluating the efficacy of stereotactic radiotherapy for metastatic colorectal cancer: A retrospective review of clinical outcomes.\",\"authors\":\"Beini Chen, Justin Smith, Revadhi Chelvarajah, Alexandra Knesl, Parushka Moodley, David Pryor, Mark B Pinkham, G Tao Mai, Howard Y Liu, Yoo Young Lee\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Despite advances in systemic therapy, survival in metastatic colorectal cancer (mCRC) remains poor. The utility of stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS), allowing dose escalation to achieve improved local control has risen in the treatment of mCRC. However, local control (LC) and overall survival (OS) varies widely between studies, and prognostic factors are not well defined.</p><p><strong>Methods: </strong>We retrospectively assessed LC and OS in patients with mCRC treated with SBRT/SRS between 2014 and 2022.</p><p><strong>Results: </strong>124 Patients were treated during the study period. Median follow up was 16.4 months (0.2-93.1 months). There were 310 lesions treated with 53% located in the brain, 22% lung, 16% liver, 4% bone, 4% nodal and 1% other. Biologically effective dose (BED10) ranged from 33.6 to 151.2 Gy.LC was 75% (95% CI 67-81%) at 1 year and 65% (95%CI 56-73%) 2 years. On multivariable analysis (MVA), older age (HR 1.04, <i>p</i> = 0.001) and tumour volume >2.5 cc (HR 3.13, <i>p</i> < 0.001) were associated with worse LC.OS from first course of SBRT/SRS was 68% at 1 year (95%CI 58-76%), and 48% at 2 years (95%CI 38-58%). On MVA, ≥2 or more lines of systemic therapy (HR 3.04, <i>p</i> < 0.001) and brain metastases (HR 4.24, <i>p</i> = 0.001) were associated with shorter OS. 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引用次数: 0
摘要
背景：尽管全身治疗取得了进展，但转移性结直肠癌（mCRC）的生存率仍然很低。立体定向放射治疗（SBRT）和立体定向放射外科（SRS）的应用，允许剂量递增以实现更好的局部控制，在mCRC的治疗中得到了提高。然而，不同研究之间的局部控制（LC）和总生存（OS）差异很大，预后因素也没有很好的定义。方法：我们回顾性评估2014年至2022年间接受SBRT/SRS治疗的mCRC患者的LC和OS。结果：124例患者在研究期间接受治疗。中位随访时间为16.4个月（0.2 ~ 93.1个月）。共治疗310例病变，其中53%位于脑部，22%位于肺部，16%位于肝脏，4%位于骨骼，4%位于淋巴结，1%位于其他部位。生物有效剂量（BED10）为33.6 ~ 151.2 Gy。1年时LC为75% (95%CI 67-81%)， 2年时LC为65% （95%CI 56-73%）。在多变量分析（MVA）中，年龄较大（HR 1.04, p = 0.001）和肿瘤体积>2.5 cc （HR 3.13, p < 0.001）与LC恶化相关。首个SBRT/SRS疗程1年生存率为68% (95%CI 58-76%)， 2年生存率为48% （95%CI 38-58%）。在MVA中，≥2线或更多的全身治疗（HR 3.04, p < 0.001）和脑转移（HR 4.24, p = 0.001）与较短的生存期相关。生存时间足够长，接受≥2个疗程的SBRT/SRS （HR 0.20, p = 0.004）与较长的OS相关。结论：本研究表明SBRT和SRS可有效地局部控制肿瘤，LC与肿瘤体积有关。
Evaluating the efficacy of stereotactic radiotherapy for metastatic colorectal cancer: A retrospective review of clinical outcomes.
Background: Despite advances in systemic therapy, survival in metastatic colorectal cancer (mCRC) remains poor. The utility of stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS), allowing dose escalation to achieve improved local control has risen in the treatment of mCRC. However, local control (LC) and overall survival (OS) varies widely between studies, and prognostic factors are not well defined.
Methods: We retrospectively assessed LC and OS in patients with mCRC treated with SBRT/SRS between 2014 and 2022.
Results: 124 Patients were treated during the study period. Median follow up was 16.4 months (0.2-93.1 months). There were 310 lesions treated with 53% located in the brain, 22% lung, 16% liver, 4% bone, 4% nodal and 1% other. Biologically effective dose (BED10) ranged from 33.6 to 151.2 Gy.LC was 75% (95% CI 67-81%) at 1 year and 65% (95%CI 56-73%) 2 years. On multivariable analysis (MVA), older age (HR 1.04, p = 0.001) and tumour volume >2.5 cc (HR 3.13, p < 0.001) were associated with worse LC.OS from first course of SBRT/SRS was 68% at 1 year (95%CI 58-76%), and 48% at 2 years (95%CI 38-58%). On MVA, ≥2 or more lines of systemic therapy (HR 3.04, p < 0.001) and brain metastases (HR 4.24, p = 0.001) were associated with shorter OS. Living long enough to receive ≥2 courses of SBRT/SRS (HR 0.20, p = 0.004) was associated with longer OS.
Conclusion: This study demonstrates that SBRT and SRS offer effective local control, and LC is associated with tumour volume.
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