O'Cathail, SM;
Smith, T;
Owens, R;
Zeniou, A;
Tsang, Y;
Lp Holyoake, D;
Murray, L;
... Hawkins, MA; + view all
(2020)
Superior outcomes of nodal metastases compared to visceral sites in oligometastatic colorectal cancer treated with stereotactic ablative radiotherapy.
Radiotherapy and Oncology
10.1016/j.radonc.2020.08.012.
(In press).
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Abstract
BACKGROUND: Stereotactic ablative radiotherapy (SBRT) is a radical option for oligometastatic colorectal cancer (CRC) patients, but most data relate to visceral metastases. METHODS: A prospective, multi-centre database of CRC patients treated with SBRT was interrogated. Inclusion criteria were ECOG PS 0-2, ≤ 3 sites of disease, a disease free interval of > 6 months unless synchronous liver metastases. Primary endpoints were local control (LC), progression free survival (PFS) and overall survival (OS). RESULTS: 163 patients (172 metastases) were analysed. The median FU was 16 months (IQR 12.2 - 22.85). The LC at 1 year was 83.8% (CI 76.4% - 91.9%) with a PFS of 55% (CI 47% - 64.7%) respectively. LC at 1 year was 90% (CI 83% - 99%) for nodal metastases (NM), 75% (63% - 90%) for visceral metastases (VM). NM had improved median PFS (9 vs 19 months) [HR 0.6, CI 0.38 - 0.94, p = 0.032] and median OS (32 months vs not reached) [HR 0.28, CI 0.18 - 0.7, p = 0.0062] than VM, regardless of whether the NM were located inside or outside the pelvis. On multivariate analysis, NM and ECOG PS 0 were significant good prognostic factors. An exploratory analysis suggests KRAS WT is also a good prognostic factor. CONCLUSION: Nodal site is an important prognostic determinant of SBRT that should incorporated into patient selection. We hypothesise this may have an immunoediting basis.
| Type: | Article |
|---|---|
| Title: | Superior outcomes of nodal metastases compared to visceral sites in oligometastatic colorectal cancer treated with stereotactic ablative radiotherapy |
| Location: | Ireland |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.radonc.2020.08.012 |
| Publisher version: | https://doi.org/10.1016/j.radonc.2020.08.012 |
| Language: | English |
| Additional information: | © 2020 The Authors. Published by Elsevier B.V. under a Creative Commons license (https://creativecommons.org/licenses/by/4.0/). |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10109077 |
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