Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea.
J Surg Oncol. 2012 Aug 1;106(2):138-43. doi: 10.1002/jso.23058. Epub 2012 Feb 1.
This study evaluated the treatment result of high dose stereotactic body radiation therapy (SBRT) for colorectal oligometastases.
Between 2003 and 2009, 41 patients with 50 lesions confined to one organ from colorectal cancer (CRC) and treated with high dose SBRT ≥45 Gy were retrospectively reviewed. Lymph nodes (LNs) (18 patients) were the most frequent sites followed in order by lung (12) and liver (11). SBRT doses ranged from 45 to 60 Gy in three fractions (median 48 Gy). The cumulative gross tumor volume (GTV) ranged from 2 to 123 ml (median 13 ml).
The median follow-up period from the SBRT date was 28 months (range, 6-65 months). The 3-year local control and overall survival rates were 64 and 60%, and the respective 5-year rates were 57 and 38%. Cumulative GTV and SBRT dose were statistically significant prognostic factors for local control. The grade 3 or 4 complications occurred in three patients (7%).
High dose SBRT for colorectal oligometastases was found to produce results comparable with surgical series. To improve local control, dose higher than 48 Gy are recommend when possible, but further study will be required to define the optimal normal tissue constraints and acceptable toxicity.
本研究评估了大剂量立体定向体放射治疗（SBRT）治疗结直肠寡转移的疗效。
2003 年至 2009 年间，回顾性分析了 41 例结直肠癌（CRC）局限于单一器官且接受大剂量 SBRT（≥45Gy）治疗的 50 个病灶的患者。淋巴结（LN）（18 例）是最常见的转移部位，其次是肺（12 例）和肝（11 例）。SBRT 剂量范围为 45 至 60Gy，分 3 次（中位数 48Gy）。累积大体肿瘤体积（GTV）范围为 2 至 123ml（中位数 13ml）。
从 SBRT 日期开始的中位随访时间为 28 个月（范围，6-65 个月）。3 年局部控制率和总生存率分别为 64%和 60%，5 年分别为 57%和 38%。累积 GTV 和 SBRT 剂量是局部控制的统计学显著预后因素。3 例（7%）患者发生 3 或 4 级并发症。
对于结直肠寡转移灶，大剂量 SBRT 的疗效与手术系列相当。为了提高局部控制率，建议在可能的情况下使用高于 48Gy 的剂量，但需要进一步的研究来确定最佳的正常组织限制和可接受的毒性。
