title: Stereotactic Ablative Radiotherapy (SABR) in inoperable oligometastatic disease from colorectal cancer: a safe and effective approach.
abstract: BACKGROUND
  To assess the safety and efficacy of Stereotactic Ablative Radiotherapy (SABR) in oligometastatic patients from colorectal cancer.
  
  
  METHODS
  82 patients with 1-3 inoperable metastases confined to one organ (liver or lung), were treated with SABR for a total of 112 lesions in an observational study. Prescription dose ranged between 48 and 75 Gy in 3 or 4 consecutive fractions. Primary end-points were local control (LC), overall survival (OS) and progression-free survival (PFS). Secondary end-point was toxicity.
  
  
  RESULTS
  Median follow-up was 24 months (range 3-47). One, two and three years LC rate was 90%,80% and 75% (85%,75% and 70% for lung and 95%, 90% and 85% for liver metastases; no statistically significance was found). The difference in LC between the subgroup of lesions treated with ≥ 60 Gy (n = 58) and those irradiated with <60 Gy (n = 52) was statistically significant, with a 1, 2 and 3 yrs LC of 97%,92% and 83% for the higher dose, compared to 85%,70% and 70% for the lower dose (p < 0.04). Median OS was 32 months. Actuarial OS rate at 1, 2 and 3 yrs was 85%,65% and 43%. Univariate analysis showed a correlation only between OS and cumulative GTV > 3 cm (p < 0.02). Median PFS was 14 months, with a PFS rate of 56% at 1 yr and 40% at 2-3 yrs, without correlation with the site and prescription dose (p < 0.48 and p < 0.56). No patients experienced radiation-induced liver disease or grade >3 toxicity.
  
  
  CONCLUSIONS
  SABR is a safe and feasible alternative treatment of oligometastatic colorectal liver and lung metastases in patients not amenable to surgery or other ablative treatments.
authors.affiliation: Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Rozzano, MI, Italy. tiziana.comito@humanitas.it.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Comito
authors.forename: Luca
authors.initials: L
authors.lastname: Cozzi
authors.forename: Elena
authors.initials: E
authors.lastname: Clerici
authors.forename: Maria Concetta
authors.initials: MC
authors.lastname: Campisi
authors.forename: Rocco Luca Emanuele
authors.initials: RL
authors.lastname: Liardo
authors.forename: Pierina
authors.initials: P
authors.lastname: Navarria
authors.forename: AnnaMaria
authors.initials: A
authors.lastname: Ascolese
authors.forename: Angelo
authors.initials: A
authors.lastname: Tozzi
authors.forename: Cristina
authors.initials: C
authors.lastname: Iftode
authors.forename: Fiorenza
authors.initials: F
authors.lastname: De Rose
authors.forename: Elisa
authors.initials: E
authors.lastname: Villa
authors.forename: Nicola
authors.initials: N
authors.lastname: Personeni
authors.forename: Lorenza
authors.initials: L
authors.lastname: Rimassa
authors.forename: Armando
authors.initials: A
authors.lastname: Santoro
authors.forename: Antonella
authors.initials: A
authors.lastname: Fogliata
authors.forename: Pietro
authors.initials: P
authors.lastname: Mancosu
authors.forename: Stefano
authors.initials: S
authors.lastname: Tomatis
authors.forename: Marta
authors.initials: M
authors.lastname: Scorsetti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D016634:Radiosurgery / Q000009:adverse effects* / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome