title: Stereotactic body radiation therapy using three fractions for isolated lung recurrence from colorectal cancer.
abstract: OBJECTIVE
  To determine the feasibility of stereotactic body radiotherapy (SBRT) using 3 fractions for isolated colorectal lung metastases.
  
  
  METHODS
  From June 2003 to December 2006, 13 cases of isolated pulmonary metastasis from colorectal cancer were treated by SBRT due to an inoperable state (7 patients), or the patient's refusal to undergo surgical excision (6 patients). All patients underwent chemotherapy for salvage treatment. SBRT doses ranged from 39 to 51 Gy in 3 fractions. Nine patients had a solitary lesion, 3 patients had 2 lesions, and 1 patient had 3 lesions. Median tumor volume for the 18 lesions was 5.9 ml (range 1.6-45 ml).
  
  
  RESULTS
  Follow-up duration was 15-57 months. Three-year overall survival, local control and progression-free survival rates were 64.7, 52.7 and 11.5%, respectively.Univariate analysis showed that total internal target volume was a significant prognostic factor for local control. During the follow-up, 11 of the 13 patients experienced local recurrence, distant metastasis or both. The most frequent site of failure was in a nontargeted lung region. No severe complication was attributed to SBRT.
  
  
  CONCLUSIONS
  Our study suggests the potential feasibility of SBRT for selected patients with 1-3 small metastatic nodules. A further larger-scale study is required to define the indications for SBRT in cases with isolated pulmonary metastasis from colorectal cancer.
authors.affiliation: Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Nowon-Gu, Seoul, Korea. mskim@kcch.re.kr
authors.forename: Mi-Sook
authors.initials: MS
authors.lastname: Kim
authors.forename: Sung Yul
authors.initials: SY
authors.lastname: Yoo
authors.forename: Chul Koo
authors.initials: CK
authors.lastname: Cho
authors.forename: Hyung Jun
authors.initials: HJ
authors.lastname: Yoo
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Choi
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Jin Kyu
authors.initials: JK
authors.lastname: Kang
authors.forename: Dong Han
authors.initials: DH
authors.lastname: Lee
authors.forename: Dae Yong
authors.initials: DY
authors.lastname: Hwang
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Moon
authors.forename: Min Suk
authors.initials: MS
authors.lastname: Kim
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Kang
authors.forename: Young Han
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D017211:Treatment Failure