Dataset Information

Predicting the benefit of stereotactic body radiotherapy of colorectal cancer metastases.

ABSTRACT:

Aim

To evaluate Stereotactic body radiotherapy (SBRT) in metastatic colorectal cancer (mCRC) and identify the benefit of the treatment by using a predictive algorithm.

Methods

85 patients treated with SBRT for mCRC were retrospectively analyzed. The CLInical Categorical Algorithm (CLICAL©) was used to predict probability of relapse after SBRT. Variables pre-SBRT were tested for significance for time to relapse (TTR). The patients' CLICAL© score was the mean of sub-scores of each significant variable's effect on the endpoint. Patients with similar scores were grouped into four signatures dependent on level of benefit after SBRT.

Results

Median age was 69 years (42-88), 63 % had a performance status 0 and 47 % were treated for a single metastasis. At the time of the analysis, 90 % had relapsed (95 % out-of-field). Median TTR was 7.3 months (4.6-8.5), and the 2-year relapse-free rate was 15 % (95 %CI = 7-22). The CLICAL© signature III-IV predicted a low risk of relapse if receiving high dose SBRT to all metastases or to lung metastases only. Signature I-II had a short TTR, why SBRT for these patients was judged non-beneficial.

Conclusion

The benefit from SBRT varies among mCRC patients. CLICAL© may serve as a screening tool for SBRT referrals but needs to be validated.

SUBMITTER: Lindberg S

PROVIDER: S-EPMC9356237 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Publications

Predicting the benefit of stereotactic body radiotherapy of colorectal cancer metastases.

Lindberg Sara S Onjukka Eva E Wersäll Peter P Staff Caroline C Lewensohn Rolf R Masucci Giuseppe G Lindberg Karin K

Clinical and translational radiation oncology 20220721

<h4>Aim</h4>To evaluate Stereotactic body radiotherapy (SBRT) in metastatic colorectal cancer (mCRC) and identify the benefit of the treatment by using a predictive algorithm.<h4>Methods</h4>85 patients treated with SBRT for mCRC were retrospectively analyzed. The CLInical Categorical Algorithm (CLICAL©) was used to predict probability of relapse after SBRT. Variables pre-SBRT were tested for significance for time to relapse (TTR). The patients' CLICAL© score was the mean of sub-scores of each s ...[more]

PMID: 35942398

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Project description:Prostate cancer is the most common non-cutaneous cancer in males. There are a number of options for patients with localized early stage disease, including active surveillance for low-risk disease, surgery, brachytherapy, and external beam radiotherapy. Increasingly, external beam radiotherapy, in the form of dose-escalated and moderately hypofractionated regimens, is being utilized in prostate cancer, with randomized evidence to support their use. Stereotactic body radiotherapy, which is a form of extreme hypofractionation, delivered with high precision and conformality typically over 1 to 5 fractions, offers a more contemporary approach with several advantages including being non-invasive, cost-effective, convenient for patients, and potentially improving patient access. In fact, one study has estimated that if half of the patients currently eligible for conventional fractionated radiotherapy in the United States were treated instead with stereotactic body radiotherapy, this would result in a total cost savings of US$250 million per year. There is also a strong radiobiological rationale to support its use, with prostate cancer believed to have a low α/β ratio and therefore being preferentially sensitive to larger fraction sizes. To date, there are no published randomized trials reporting on the comparative efficacy of stereotactic body radiotherapy compared to alternative treatment modalities, although multiple randomized trials are currently accruing. Yet, early results from the randomized phase III study of HYPOfractionated RadioTherapy of intermediate risk localized Prostate Cancer (HYPO-RT-PC) trial, as well as multiple single-arm phase I/II trials, indicate low rates of late adverse effects with this approach. In patients with low- to intermediate-risk disease, excellent biochemical relapse-free survival outcomes have been reported, albeit with relatively short median follow-up times. These promising early results, coupled with the enormous potential cost savings and implications for resource availability, suggest that stereotactic body radiotherapy will take center stage in the treatment of prostate cancer in the years to come.

Dataset Information

Predicting the benefit of stereotactic body radiotherapy of colorectal cancer metastases.

Aim

Methods

Results

Conclusion

Publications

Predicting the benefit of stereotactic body radiotherapy of colorectal cancer metastases.

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