Department of Medical Oncology and Comprehensive Cancer Center, Klinikum Grosshadern, LMU, Munich, Germany.
Acta Oncol. 2013 Jun;52(5):971-7. doi: 10.3109/0284186X.2013.766362. Epub 2013 Feb 14.
Stereotactic radiation therapy is an evolving modality to treat otherwise unresectable liver metastases. In this analysis, two local therapies: 1) single session robotic radiosurgery (RRS) and 2) percutaneous radiofrequency ablation (RFA) were compared in a total of 60 heavily pretreated colorectal cancer patients.
Thirty patients with a total of 35 colorectal liver metastases not qualifying for surgery that were treated in curative intent with RRS were prospectively followed. To compare efficacy of both treatment modalities, patients treated with RFA during the same period of time were matched according to number and size of the treated lesions. Local tumor control, local disease free survival (DFS), and freedom from distant recurrence (FFDR) were analyzed for efficacy. Treatment-related side effects were recorded for comparison.
The median diameter of the treated lesions was 33 mm (7-53 mm). Baseline characteristics did not differ significantly between the groups. One- and two-year local control rates showed no significant difference but favored RRS (85% vs. 65% and 80% vs. 61%, respectively). A significantly longer local DFS of patients treated with RRS compared to RFA (34.4 months vs. 6.0 months; p < 0.001) was found. Both, median FFDR (11.4 months for RRS vs. 7.1 months for RFA p = 0.25) and the recurrence rate (67% for RRS and 63% for RFA, p > 0.99) were comparable.
Single session RRS is a safe and effective method to treat colorectal liver metastases. In this analysis, a trend towards longer DFS was seen in patients treated with RRS when compared to RFA.
立体定向放射治疗是一种治疗无法切除的肝转移瘤的新兴方法。在这项分析中，我们比较了两种局部治疗方法：1）单次机器人放射外科手术（RRS）和 2）经皮射频消融（RFA），共 60 例经大量预处理的结直肠癌患者接受了这两种治疗。
前瞻性随访了 30 例共 35 个不符合手术条件的结直肠肝转移灶患者，这些患者接受了 RRS 的根治性治疗。为了比较两种治疗方法的疗效，我们根据治疗病变的数量和大小，对同期接受 RFA 治疗的患者进行了匹配。分析了局部肿瘤控制、局部无病生存率（DFS）和无远处复发率（FFDR）的疗效。记录了治疗相关的副作用，以便进行比较。
治疗病变的中位直径为 33mm（7-53mm）。两组患者的基线特征无显著差异。1 年和 2 年局部控制率无显著差异，但 RRS 更有优势（分别为 85% vs. 65%和 80% vs. 61%）。RRS 治疗的患者局部 DFS 明显长于 RFA（34.4 个月 vs. 6.0 个月；p<0.001）。RRS 和 RFA 的中位 FFDR（分别为 11.4 个月和 7.1 个月，p=0.25）和复发率（分别为 67%和 63%，p>0.99）相当。
单次 RRS 是治疗结直肠肝转移的一种安全有效的方法。在这项分析中，与 RFA 相比，RRS 治疗的患者 DFS 更长。
