title: Phase II study on stereotactic body radiotherapy of colorectal metastases.
abstract: Surgical resection provides long term survival in approximately 30% of patients with colorectal carcinoma (CRC) liver metastases. However, only a limited number of patients with CRC-metastases are amendable for surgery. We have tested the effect of stereotactic body radiotherapy (SBRT) in the treatment of inoperable patients with CRC-metastases. Sixty-four patients with a total number of 141 CRC-metastases in the liver (n = 44), lung (n = 12), lymph nodes (n = 3), suprarenal gland (n = 1) or two organs (n = 4) were treated with SBRT with a central dose of 15 Gy x 3 within 5-8 days. Median follow-up was 4.3 years. After 2 years, actuarial local control was 86% and 63% in tumor and patient based analysis, respectively. Nineteen percent were without local or distant progression after 2 years and overall survival was 67, 38, 22, 13, and 13% after 1, 2, 3, 4 and 5 years, respectively. One patient died due to hepatic failure, one patient was operated for a colonic perforation and two patients were conservatively treated for duodenal ulcerations. Beside these, only moderate toxicities such as nausea, diarrhoea and skin reactions were observed. SBRT in patients with inoperable CRC-metastases resulted in high probability of local control and promising survival rate. One toxic death and few severe reactions were observed. For the majority of patients, the treatment related toxicity was moderate.
authors.affiliation: Department of Oncology, Aarhus University Hospital.
authors.forename: Morten
authors.initials: M
authors.lastname: Hoyer
authors.forename: Henrik
authors.initials: H
authors.lastname: Roed
authors.forename: Anders
authors.initials: A
authors.lastname: Traberg Hansen
authors.forename: Lars
authors.initials: L
authors.lastname: Ohlhuis
authors.forename: Jorgen
authors.initials: J
authors.lastname: Petersen
authors.forename: Hanne
authors.initials: H
authors.lastname: Nellemann
authors.forename: Anne
authors.initials: A
authors.lastname: Kiil Berthelsen
authors.forename: Cai
authors.initials: C
authors.lastname: Grau
authors.forename: Svend
authors.initials: S
authors.lastname: Aage Engelholm
authors.forename: Hans
authors.initials: H
authors.lastname: Von der Maase
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome