Stereotactic body radiotherapy for isolated paraaortic lymph node recurrence from colorectal cancer.
OBJECTIVE
To evaluate the efficacy and complications of stereotactic body radiotherapy in localized paraaortic lymph node recurrence from colorectal cancer.


METHODS
From 2003 to 2009, 7 patients with paraaortic lymph node recurrence (1-3 lesions) from colorectal cancer were treated with stereotactic body radiotherapy. Total gross tumor volumes ranged from 4 to 40 mL. The doses were escalated from 36 Gy/patient to 51 Gy/patient and were delivered in 3 fractions.


RESULTS
One and 3 year overall survival rates were 100% and 71.4%, respectively, and median survival was 37 mo. Grade IV intestinal obstruction was reported in 1 of 7 patients. This patient received 48 Gy in 3 fractions with a maximum point dose to the intestine of 53 Gy and V(45Gy) = 3.6 mL. However, 6 patients received an intestinal maximum point dose of < 51 Gy and V(45Gy) of < 1 mL, and did not develop any severe complications.


CONCLUSIONS
This pilot study suggests selected paraaortic lymph node recurrence (1-3 closed lesions) that failed to respond to chemotherapy can be potentially salvaged by stereotactic body radiotherapy.
Kim
Mi-Sook
MS
Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 215-4 Gongneung-dong, Nowon-gu, Seoul 139-706, South Korea. mskim@kcch.re.kr
Cho
Chul Koo
CK
Yang
Kwang Mo
KM
Lee
Dong Han
DH
Moon
Sun Mi
SM
Shin
Young Joo
YJ
D000230:Adenocarcinoma / Q000532:radiotherapy* / Q000601:surgery; D000368:Aged; D001011:Aorta; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy* / Q000601:surgery; D010865:Pilot Projects; D016634:Radiosurgery; D012004:Rectal Neoplasms / Q000473:pathology*; D012189:Retrospective Studies