Radiosensitivity of Colon and Rectal Lung Oligometastasis Treated With Stereotactic Ablative Radiotherapy.

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Version: Final published version
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Serval ID
serval:BIB_265E1A26511F
Type
Article: article from journal or magazin.
Collection
Publications
Title
Radiosensitivity of Colon and Rectal Lung Oligometastasis Treated With Stereotactic Ablative Radiotherapy.
Journal
Clinical colorectal cancer
Author(s)
Kinj R., Bondiau P.Y., François E., Gérard J.P., Naghavi A.O., Leysalle A., Chamorey E., Evesque L., Padovani B., Ianessi A., Benezery K., Doyen J.
ISSN
1938-0674 (Electronic)
ISSN-L
1533-0028
Publication state
Published
Issued date
09/2017
Peer-reviewed
Oui
Volume
16
Number
3
Pages
e211-e220
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Patients with metastatic colorectal cancer (CRC) may present with oligometastatic lung lesions for which stereotactic ablative radiotherapy (SABR) can be utilized. This study aims to report efficacy and prognostic factors associated with colorectal lung metastases treated with SABR.
This is a retrospective study including patients who presented with lung oligometastasis from CRC treated with SABR from September 2007 to November 2014.
We identified 53 oligometastatic patients with 87 lung lesions. The median prescription dose was 60 Gy in 3 fractions (median biological effective dose of 180 Gy). The median follow up was 33 months. The 1- and 2-year local control, metastasis-free survival, and overall survival were 79.8% and 78.2%, 29.2% and 16.2%, and 83.8% and 69.3%, respectively. On multivariate analysis, rectal primary site (P = .001) and > 2 metastases (P = .02) were significantly associated with a lower local control rate. Rectal lesions were associated with higher radiation dose (169.3 Gy vs. 153.3 Gy; P = .01) and higher rate of KRAS mutations (73.3% vs. 40.4%; P = .02). KRAS mutation did not predict for local control, but predicted for a 1-year metastasis-free survival detriment (0% vs. 37.5%; P = .04), when compared with KRAS wild-type. On multivariate analysis, there is an overall survival detriment associated with gross tumor volume ≥ 3266 mm <sup>3</sup> (P = .03) and > 2 metastases (P = .04).
In CRC, oligometastatic lung lesions treated with SABR had a worse outcome in patients presenting with a rectal primary, > 2 metastases, or treated with a larger gross tumor volume. More aggressive treatment may be considered in this subset of patients to improve outcome.
Keywords
Aged, Aged, 80 and over, Cohort Studies, Colorectal Neoplasms/mortality, Colorectal Neoplasms/pathology, Colorectal Neoplasms/radiotherapy, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Lung Neoplasms/mortality, Lung Neoplasms/radiotherapy, Lung Neoplasms/secondary, Male, Middle Aged, Proto-Oncogene Proteins p21(ras)/genetics, Radiation Tolerance, Radiosurgery/methods, Retrospective Studies, Treatment Outcome, Colon cancer, High radiation dose, KRAS mutation, Rectal cancer, Survival
Pubmed
Web of science
Create date
23/08/2021 11:38
Last modification date
24/09/2024 11:41
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