Kang Su Jin, Park Jongmoo, Choi Gyu-Seog, Kim Jong Gwang, Park Jun Seok, Kim Hye Jin, Baek Jin Ho, Kang Byung Woog, Seo An Na, Park Shin-Hyung, Bae Bong Kyung, Kang Min Kyu, Park Soo Yeun
Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
PLoS One. 2025 Jan 3;20(1):e0313438. doi: 10.1371/journal.pone.0313438. eCollection 2025.
This study aimed to identify radiotherapy dosimetric parameters related to local failure (LF)-free survival (LFFS) in patients with lung and liver oligometastases from colorectal cancer treated with stereotactic body radiotherapy (SBRT). We analyzed 75 oligometastatic lesions in 55 patients treated with SBRT between January 2014 and December 2021. There was no constraint or intentional increase in maximum dose. LF was defined as the progression of the treated lesion until the last follow-up or death. The dose distributions were recalculated using Monte Carlo-based algorithms. The significance of the planning target volume (PTV) biologically effective dose (BED) 10s (D2, D95, D98, Dmean) in LFFS was evaluated using Cox regression, considering sex, age, primary cancer, tumor site, oligometastatic status, multiplicity, and either tumor size or one of the volume parameters. LF occurred in 23.4% of the lesions. Lesions showing LF received significantly lower PTV D2 (146 ± 21 vs. 164 ± 23, p = 0.006). Multivariate analysis revealed that PTV D2 (< 159 Gy10 vs. ≥ 159 Gy10) was the sole dosimetric parameter associated with LFFS. Tumors equal to or larger than the median size/volume yet receiving < 159 Gy10 of PTV D2 showed the lowest LFFS following stratification by median PTV D2 combined with tumor size or volume parameters. The maximum dose (PTV D2) was significantly associated with LFFS after SBRT for lung and liver oligometastases from colorectal cancer. Increasing the maximum dose may be beneficial for managing larger tumors.
本研究旨在确定接受立体定向体部放疗（SBRT）的结直肠癌肺和肝寡转移患者中与无局部失败（LF）生存率（LFFS）相关的放疗剂量学参数。我们分析了2014年1月至2021年12月期间接受SBRT治疗的55例患者的75个寡转移病灶。未对最大剂量进行限制或有意增加。LF定义为直至最后一次随访或死亡时治疗病灶的进展。使用基于蒙特卡洛的算法重新计算剂量分布。考虑性别、年龄、原发癌、肿瘤部位、寡转移状态、病灶数量以及肿瘤大小或体积参数之一，采用Cox回归评估计划靶体积（PTV）生物等效剂量（BED）10s（D2、D95、D98、Dmean）在LFFS中的意义。23.4%的病灶出现LF。出现LF的病灶接受的PTV D2显著更低（146±21 vs. 164±23，p = 0.006）。多变量分析显示，PTV D2（<159 Gy10 vs.≥159 Gy10）是与LFFS相关的唯一剂量学参数。在按PTV D2中位数结合肿瘤大小或体积参数分层后，等于或大于中位数大小/体积但PTV D2<159 Gy10的肿瘤显示出最低的LFFS。对于结直肠癌肺和肝寡转移，SBRT后的最大剂量（PTV D2）与LFFS显著相关。增加最大剂量可能有利于治疗较大的肿瘤。
