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Title
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Phase II study of helical tomotherapy in the multidisciplinary treatment of oligometastatic colorectal cancer
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Author
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Abstract
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| Background: Complete metastasectomy provides a real chance for long-term survival in patients with oligometastatic colorectal cancer (CRC). For inoperable patients, we evaluated in this study intensity-modulated and image-guided radiotherapy (IMRT-IGRT) by helical tomotherapy. Methods: Twenty-four CRC patients with <= 5 metastases were enrolled, receiving a dose of 50 Gy in fractions of 5 Gy. No limitations concerning dimension or localization of the metastases were imposed. Whole body PET-CT was performed at baseline and 3 months after the initiation of RT to evaluate the metabolic response rate according to PET Response Criteria in Solid Tumors (PERCIST) version 1.0. Results: A total of 53 metastases were treated. Seventeen patients (71%) received previously >= 1 line of chemotherapy for metastatic disease, displaying residual (n = 7) or progressive (n = 10) metabolic active oligometastatic disease at time of inclusion. Most common sites were the lung, liver and lymphnodes. One patient (4%) experienced grade 3 dysphagia. Twenty-two patients were evaluated by post-treatment PET-CT. Twelve patients achieved a complete (n = 6) or partial (n = 6) metabolic response, resulting in an overall metabolic response rate of 55%. At a median follow-up of 10 months, 7 patients (29%) are in remission, of which 5 received previous chemotherapy with residual oligometastatic disease at time of inclusion. The actuarial 1-year local control, progression-free survival, and overall survival were 54%, 14% and 78%. Conclusions: Helical tomotherapy delivering 10 fractions of 5 Gy resulted in a metabolic response rate of 55%, and appeared to be attractive as consolidation of inoperable oligometastatic disease after effective chemotherapy. |
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Language
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English
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Source (journal)
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Radiation oncology. - London
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Publication
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London
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2012
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ISSN
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1748-717X
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DOI
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10.1186/1748-717X-7-34
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Volume/pages
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7
(2012)
, 9 p.
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Article Reference
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34
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ISI
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000304532400001
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Medium
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E-only publicatie
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Full text (Publisher's DOI)
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