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. 2023 Feb 13;15(4):1195.
doi: 10.3390/cancers15041195.

Stereotactic Body Radiotherapy versus Surgery for Lung Metastases from Colorectal Cancer: Single-Institution Results

Nagore Garcia-Exposito  1 , Ricard Ramos  2 , Valentin Navarro-Perez  3 , Kevin Molina  4 , Maria Dolores Arnaiz  1 , Susana Padrones  5 , Jose Carlos Ruffinelli  4 , Cristina Santos  4 , Ferran Guedea  1 , Arturo Navarro-Martin  1
Affiliations

Stereotactic Body Radiotherapy versus Surgery for Lung Metastases from Colorectal Cancer: Single-Institution Results

Nagore Garcia-Exposito et al. Cancers (Basel). .

Abstract

Background: Surgery and stereotactic body radiotherapy (SBRT) are two of the options available as local treatments for pulmonary oligometastases from colorectal cancer (CRC). We hypothesized that SBRT would have, at least, a similar local control rate to surgery.

Methods: We identified an initial cohort of 100 patients with CRC who received SBRT or surgery for lung metastases. This was then narrowed down to 75 patients: those who underwent surgery (n = 50) or SBRT (n = 25) as their first local thoracic treatment between 1 January 2004 and 29 December 2017. The Kaplan-Meier method was used to calculate lung-progression-free survival (L-PFS) and overall survival (OS).

Results: The 1 and 2-year L-PFS was 85% and 70% in the surgical group and 87% and 71% in the SBRT group, respectively (p = 0.809). No significant differences were found between the two groups in terms of OS. The biologically effective dose (BED), age and initial CRC stage did not have a significant effect on local control or survival. No grade 3 or above acute- or late-toxicity events were reported.

Conclusions: These results add retrospective evidence that SBRT and surgery have similar results in terms of OS and local control in patients with lung oligometastases from CRC.

Keywords: colorectal cancer; lung metastases; metastasectomy; oligometastases; stereotactic body radiotherapy; wedge resection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Impact of age on L-PFS. p = 0.73.
Figure A2
Figure A2
(a) L-PFS curves according to age at diagnosis of M1 (>70 or ≤70 years); (b) L-PFS curves according to treatment received. p = 0.860.
Figure A3
Figure A3
(a) Impact of initial stage and treatment on local control (p = 0. 62); (b) impact of initial stage and treatment on overall survival (p = 0.201).
Figure A4
Figure A4
(a) Impact of BED on OS; (b) impact of BED on L-PFS.
Figure A5
Figure A5
Kaplan–Meier curve of overall survival according to treatment received. p = 0.628.
Figure 1
Figure 1
Consort diagram. Pathological confirmation of pulmonary metastases was not required.
Figure 2
Figure 2
Overall survival depending on the type of first progression (multiple versus oligo) in the initial cohort of 100 patients (OS-LP). p < 0.001.
Figure 3
Figure 3
L-PFS curves for surgery vs SBRT. Median not reached. p = 0.809.
See this image and copyright information in PMC

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