Treatment outcomes of stereotactic ablative body radiotherapy on oligometastases from colorectal cancer: early results of a single institution service evaluation.
Julie Duong, Adele Stewart-Lord, Prasana Nariyangadu, Mark Harrison, Yat Man Tsang
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引用次数: 0
Abstract
Objective: 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 CTCAE v. 4.0. 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 1 fatigue. No Grade 3 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.
Conclusion: 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 are 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 OS comparing to the number of oligometastases.
目的:立体定向消融放疗(SABR)已被认为是一种有效的无创消融治疗结直肠癌(CRC)低转移灶的方法。本研究旨在从总生存期(OS)、无进展生存期(PFS)和治疗后毒性方面报告结直肠癌寡转移性SABR的治疗结果。方法:回顾性分析2015年2月至2018年12月在单一机构接受SABR治疗的CRC异时性寡转移患者的治疗记录。采用Kaplan-Meier统计法计算OS和PFS,并按照CTCAE v. 4.0对rt后毒性数据进行评分。根据原发癌部位、原发癌治疗类型、寡转移灶数量、SABR治疗部位、原发癌治疗与寡转移灶SABR治疗间隔、生物等效剂量、累计肿瘤总体积和计划靶体积对OS和PFS的预后因素进行分析。结果:共纳入75例86例结直肠癌异时性少转移灶(包括肝、肺、淋巴结和骨)。中位年龄为65.5岁(范围42.5-87.2),中位随访时间为23.8个月(范围3.1-46.5)。估计中位PFS为14.6个月(95% CI 9.6-19.6)。估计中位OS为33.3个月(95% CI 22.9-43.7)。大多数患者对SABR耐受性良好,最常见的急性副作用是1级疲劳。在任何时间点均未报告3级或以上毒性。只有SABR治疗部位(p = 0.03)和计划靶体积累积量(p = 0.02)分别是PFS和OS的有统计学意义的独立预测因子。结论:该研究显示,SABR治疗结直肠癌异时性寡转移的PFS、OS和治疗后毒性结果适中。它强调,与转移数量相比,累积肿瘤体积可能是OS的一个更强的预后因素。知识进展:关于结直肠癌寡转移性SABR的疗效和治疗后毒性的数据有限,随访时间足够长。我们的回顾性研究表明,与低转移灶的数量相比,累积肿瘤体积可能是OS的一个更强的预后因素。