Cancer Res Treat.  2024 Jul;56(3):809-824. 10.4143/crt.2023.920.

The Clinical Efficacy of Colorectal Cancer Patients with Pulmonary Oligometastases by Sterotactic Body Ablative Radiotherapy: A Meta-Analysis

• Jeong JU
• Rim CH
• Yoo GS
• Cho WK
• Chie EK
• Ahn YC
• Lee JH
• on behalf of Korean Oligometastasis Working Group, Korean Cancer Association

• KMID: 2557668
• DOI: http://doi.org/10.4143/crt.2023.920

Abstract

Purpose
There is increasing interest in the efficacy of stereotactic ablative radiotherapy (SABR) for treating colorectal cancer (CRC) patients with oligometastases (OM), recently. The purpose of this meta-analysis was to evaluate local control (LC), progression-free survival (PFS), and overall survival (OS) of CRC patients with pulmonary OM treated with SABR and toxicities.
Materials and Methods
Studies that reported SABR for CRC patients with pulmonary OM were searched from MEDLINE and Embase. Treatment outcomes including LC, PFS, OS, and toxicities of grade 3 or higher were assessed.
Results
A total of 19 studies with 1,668 patients were chosen for this meta-analysis. Pooled 1-, 2-, and 3-year LC rates were 83.1%, 69.3%, and 63.9%, respectively. PFS rates were 44.8%, 26.5%, and 21.5% at 1, 2, and 3 years, respectively. OS rates at 1-, 2-, and 3-year were 87.5%, 69.9%, and 60.5%, respectively. The toxicity rate of grade 3 or higher was 3.6%. The effect of dose escalation was meta-analyzed using available studies.
Conclusion
Application of SABR to CRC patients with pulmonary OM achieved modest local control with acceptable toxicity according to the present meta-analysis. Further studies establishing the clinical efficacy of SABR are guaranteed.

Keyword

Ablation; Colorectal neoplasms; Lung; Oligometastasis; Radiotherapy

Figure

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  Fig. 1. Flow chart showing the idendification of relevant studies.

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  Fig. 2. Pooled estimation of local control (LC) (A), overall survival (OS) (B), and progression-free survival (PFS) (C) after stereotactic radiotherapy [28-46]. CI, confidence interval.

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  Fig. 3. Pooled estimation of local control (A) and overall survival (B) according to the radiation dose [31,35,36,42,45]. CI, confidence interval; HD, high dose with ≥ 100 Gy in biological effective dose; LD, low dose with < 100 Gy in biological effective dose.

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