Novel strategy in the treatment of liver metastases – Hepatic resection combined with stereotactic body radiotherapy

Ihnát, Peter; Skácelíková, Eva; Vávra, P; Jonszta, Tomáš; Rudinská, Lucia Ihnát; Tomášková, Hana

doi:10.1016/j.asjsur.2019.11.016

Cited by 3 publications

(2 citation statements)

References 37 publications

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“…A recent study revealed a 2-years local control rate of 89.5% using SBRT combined with resection for initially unresectable CRCLMs. 25 The safety and clinical efficacy of liver radiotherapy combined with immunotherapy are under investigation in several trials. The initial results have shown that combination therapy is quite tolerable.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Predictors in Patients With Unresectable Colorectal Cancer Liver Metastases Following Salvage Percutaneous Radiofrequency Ablation: A Single Center Preliminary Experience

Wang

Zhang

et al. 2020

Technol Cancer Res Treat

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Purpose: The purpose of this study was to investigate the clinical efficacy of salvage percutaneous radiofrequency ablation in patients with unresectable colorectal cancer liver metastases. Methods: The cohort consisted of 81 patients with 126 colorectal cancer liver metastases who underwent radiofrequency ablation between January 2012 and September 2016. The clinical data and ablation data were retrospectively analyzed. The local tumor progression-free survival, overall survival, and prognostic factors were analyzed using the log-rank test and Cox regression model. Results: The technique success rate was 99.21%. The primary efficacy rate was 100% at the 1-month follow-up. Minor complications were observed in 2 patients, which recovered within 1 week. The median local tumor progression-free survival time of all patients was 29.8 months. The absence of subsequent chemotherapy was an independent predictor of a shorter local tumor progression-free survival time ( P < 0.001, hazard ratio: 2.823, 95% confidence interval: 1.603, 4.972). The median overall survival time was 26.8 months. A lesion size greater than 3 cm ( P = 0.011, hazard ratio: 2.112, 95% confidence interval: 1.188, 3.754) and the presence of early local tumor progression ( P = 0.011, hazard ratio: 2.352, 95% confidence interval: 1.217, 4.545) were related to a shorter survival time. Conclusions: Percutaneous radiofrequency ablation is safe in patients with colorectal cancer liver metastases refractory from chemotherapy. Subsequent chemotherapy is important to enhance local control. Small lesions and favorable early responses are related to prolonged overall survival.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Predictors in Patients With Unresectable Colorectal Cancer Liver Metastases Following Salvage Percutaneous Radiofrequency Ablation: A Single Center Preliminary Experience

Wang

Zhang

et al. 2020

Technol Cancer Res Treat

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“…RFA and MWA achieve similar survival benefi ts to surgical resection for lesions that meets the size criteria (≤3 cm) (34). The application of safe stereotactic ablative radiotherapy (SABR) as a bridge to oncologic resection is challenged by large tumors, low FLR and nearby radiosensitive anatomic structures (35). Intraarterial therapies have been proposed as another modality to treat patients with advanced chemo-resistant CRLM.…”

Section: Locoregional Liver-directed Therapymentioning

confidence: 99%

Narrative review of the role of yttrium-90 selective internal radiation therapy in the surgical management of colorectal liver metastases

Moslim

Jeyarajah

2021

J Gastrointest Oncol

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The management of colorectal liver metastasis (CRLM) is complicated and benefits from a multidisciplinary team approach. Liver-directed therapy has been emerging as a modality for better progression-free control. In its early years, selective internal radiation therapy (SIRT) with yttrium-90 (Y-90) was confi ned as an end-of-line therapy. However, literature has supported other roles including: a fi rst-line treatment for CRLM alone or in combination with systemic chemotherapy; an adjunct to second or third-line chemotherapy; and a salvage treatment for chemo-refractory disease. Although future liver remnant (FLR) hypertrophy may take 3-12 months, the SIRT effect on loco-regional disease control has rendered it to be a useful tool in some pathologies with certain strategic goals. This paper reviews the use of SIRT with Y-90 in a surgical treatment pathway. This includes: (I) an element of multidisciplinary treatment of low-volume CRLMs, (II) convert an R1 to R0 resection by sterilizing the margins of tumor near critical structures, and (III) radiation lobectomy to induce contralateral hypertrophy in order to aid in a safer resection. There are many opportunities to validate the role of SIRT as a fi rst-line therapy along with surgical resection including an umbrella clinical trial design.

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Stereotactic body radiation therapy for colorectal liver metastases

Mohamad

Barry

Dawson

et al. 2022

International Journal of Hyperthermia

114

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Novel strategy in the treatment of liver metastases – Hepatic resection combined with stereotactic body radiotherapy

Cited by 3 publications

References 37 publications

Clinical Outcomes and Predictors in Patients With Unresectable Colorectal Cancer Liver Metastases Following Salvage Percutaneous Radiofrequency Ablation: A Single Center Preliminary Experience

Clinical Outcomes and Predictors in Patients With Unresectable Colorectal Cancer Liver Metastases Following Salvage Percutaneous Radiofrequency Ablation: A Single Center Preliminary Experience

Narrative review of the role of yttrium-90 selective internal radiation therapy in the surgical management of colorectal liver metastases

Stereotactic body radiation therapy for colorectal liver metastases

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