O'Cathail, S. M. , Smith, T., Owens, R., Zeniou, A., Tsang, Y., Holyoake, D. L.P., Murray, L., Harrison, M. and Hawkins, M. A. (2020) Superior outcomes of nodal metastases compared to visceral sites in oligometastatic colorectal cancer treated with stereotactic ablative radiotherapy. Radiotherapy and Oncology, 151, pp. 280-286. (doi: 10.1016/j.radonc.2020.08.012) (PMID:32866563) (PMCID:PMC7689579)
Text
222686.pdf - Published Version Available under License Creative Commons Attribution. 1MB |
Abstract
BACKGROUND:Stereotactic ablative radiotherapy (SBRT) is a radical option for oligometastatic colorectal cancer (CRC) patients, but most data relate to visceral metastases. METHODS:A prospective, multi-centre database of CRC patients treated with SBRT was interrogated. Inclusion criteria were ECOG PS 0-2, ≤ 3 sites of disease, a disease free interval of > 6 months unless synchronous liver metastases. Primary endpoints were local control (LC), progression free survival (PFS) and overall survival (OS). RESULTS:163 patients (172 metastases) were analysed. The median FU was 16 months (IQR 12.2 - 22.85). The LC at 1 year was 83.8% (CI 76.4% - 91.9%) with a PFS of 55% (CI 47% - 64.7%) respectively. LC at 1 year was 90% (CI 83% - 99%) for nodal metastases (NM), 75% (63% - 90%) for visceral metastases (VM). NM had improved median PFS (9 vs 19 months) [HR 0.6, CI 0.38 - 0.94, p = 0.032] and median OS (32 months vs not reached) [HR 0.28, CI 0.18 - 0.7, p = 0.0062] than VM, regardless of whether the NM were located inside or outside the pelvis. On multivariate analysis, NM and ECOG PS 0 were significant good prognostic factors. An exploratory analysis suggests KRAS WT is also a good prognostic factor. CONCLUSION:Nodal site is an important prognostic determinant of SBRT that should incorporated into patient selection. We hypothesise this may have an immunoediting basis.
Item Type: | Articles |
---|---|
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | O'Cathail, Dr Sean |
Authors: | O'Cathail, S. M., Smith, T., Owens, R., Zeniou, A., Tsang, Y., Holyoake, D. L.P., Murray, L., Harrison, M., and Hawkins, M. A. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cancer Sciences |
Journal Name: | Radiotherapy and Oncology |
Publisher: | Elsevier |
ISSN: | 0167-8140 |
ISSN (Online): | 1879-0887 |
Published Online: | 29 August 2020 |
Copyright Holders: | Copyright © 2020 The Authors |
First Published: | First published in Radiotherapy and Oncology 151: 280-286 |
Publisher Policy: | Reproduced under a Creative Commons licence |
University Staff: Request a correction | Enlighten Editors: Update this record