Stereotactic body radiation therapy using three fractions for isolated lung recurrence from colorectal cancer.
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.
Kim
Mi-Sook
MS
Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Nowon-Gu, Seoul, Korea. mskim@kcch.re.kr
Yoo
Sung Yul
SY
Cho
Chul Koo
CK
Yoo
Hyung Jun
HJ
Choi
Chul Won
CW
Seo
Young Seok
YS
Kang
Jin Kyu
JK
Lee
Dong Han
DH
Hwang
Dae Yong
DY
Moon
Sun Mi
SM
Kim
Min Suk
MS
Kang
Hye Jin
HJ
Kim
Young Han
YH
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