Outcomes of extra-cranial stereotactic body radiotherapy for metastatic colorectal cancer: Dose and site of metastases matter

Thompson, Robert M.; Cheung, Patrick; Chu, William; Myrehaug, Sten; Poon, Ian; Sahgal, Arjun; Soliman, Hany; Tseng, Chia‐Lin; Wong, Shun; Ung, Yee C.; Abrahão, Ana Beatriz Kinupe; Erler, Darby; Zhang, Liying; Ko, Yoo‐Joung; Chung, Hans T.

doi:10.1016/j.radonc.2019.08.018

Cited by 33 publications

(47 citation statements)

References 25 publications

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“…This study showed that SBRT offered favorable survival, disease control and symptom palliation for mCRC patients, and the proposed nomogram could provide individual prediction of OS for these patients. Some studies have compared the efficacies of SBRT among OM, OP, and LCDT (21,33). The survival results of our study were consistent with other reports that mCRC patients with OM had the highest median OS and PFS after SBRT compared with OP or LCDT.…”

Section: Discussionsupporting

confidence: 90%

“…Some large retrospective case series of mCRC for SBRT have suggested prognostic variables for survival. Favorable prognostic factors included good performance status (18,34), fewer metastases (18,34), smaller tumors (5,21,34,35), fewer number of lines of previous systemic therapy (5,21), lower CEA (21), and oligometastasis treatment indication (18,21).…”

Section: Discussionmentioning

confidence: 99%

“…This may have clinical benefits, including improved PFS, OS and life quality of patients (18)(19)(20). Local control of dominant tumors is another increasing indication for SBRT (21), a clinical situation where the local tumor may cause severe morbidity, obvious pain or obstruction symptoms. In this case, the main goal of SBRT targeting dominant tumors is to alleviate symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Stereotactic Body Radiotherapy for Metastatic Colorectal Cancer With Oligometastases, Oligoprogression, or Local Control of Dominant Tumors

Zhao

Zhu

et al. 2021

Front. Oncol.

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AimTo evaluate the clinical outcomes of metastatic colorectal cancer (mCRC) patients with oligometastases, oligoprogression, or local control of dominant tumors after stereotactic body radiotherapy (SBRT) and establish a nomogram model to predict the prognosis for these patients.Methods and MaterialsA cohort of 94 patients with 162 mCRC metastases was treated with SBRT at a single institution. Treatment indications were oligometastases, oligoprogression, and local control of dominant tumors. End points of this study were the outcome in terms of progression-free survival (PFS), overall survival (OS), local progression (LP), and cumulative incidence of starting or changing systemic therapy (SCST). In addition, univariate and multivariable analyses to assess variable associations were performed. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve.ResultsMedian PFS were 12.6 months, 6.8 months, and 3.7 months for oligometastases, oligoprogression, and local control of dominant tumors, respectively. 0-1 performance status, < 10 ug/L pre-SBRT CEA, and ≤ 2 metastases were significant predictors of higher PFS on multivariate analysis. Median OS were 40.0 months, 26.1 months, and 6.5 months for oligometastases, oligoprogression, and local control of dominant tumors, respectively. In the multivariate analysis of the cohort, the independent factors for survival were indication, performance status, pre-SBRT CEA, and PTV, all of which were selected into the nomogram. The calibration curve for probability of survival showed the good agreement between prediction by nomogram and actual observation. The C-index of the nomogram for predicting survival was 0.848.ConclusionsSBRT for metastases derived from colorectal cancer offered favorable survival and symptom palliation without significant complications. The proposed nomogram could provide individual prediction of OS for patients with mCRC after SBRT.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of Stereotactic Body Radiotherapy for Metastatic Colorectal Cancer With Oligometastases, Oligoprogression, or Local Control of Dominant Tumors

Zhao

Zhu

et al. 2021

Front. Oncol.

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“…The radiotherapy model for malignancy has transformed from conventional fraction radiotherapy (CFRT) to hypofractionated radiotherapy, which is now considered to be a new and highly effective mode of radiation therapy [1,2]. Stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery are common procedures in hypofractionated radiotherapy, especially SBRT, which is widely performed for lung cancer, colorectal cancer, liver cancer, and prostate cancer, and shows considerable improvement in the radiotherapeutic outcomes [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Relationship between the invasion of lymphocytes and cytokines in the tumor microenvironment and the interval after single brachytherapy hypofractionated radiotherapy and conventional fractionation radiotherapy in non-small cell lung Cancer

et al. 2020

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Background The effect of brachytherapy on lymphocytes and cytokines in the tumor microenvironment is unclear. This study aimed to analyze the relationship between the invasion of lymphocytes and cytokines in the tumor microenvironment and the interval after single brachytherapy hypofractionated radiotherapy (SBHFRT) and conventional fractionation radiotherapy (CFRT) in non-small cell lung cancer (NSCLC). Methods Lewis tumor-bearing mice were randomly divided into control, CFRT, and SBHFRT groups. On days 7 and 14 after radiation, the expression levels of CD86+, CD4+, CD8+, and Foxp3+ cells, and levels of Ki-67+ protein were detected by immunohistochemistry, and the tumor necrosis rate was calculated. Following this, the levels of interleukin-10 (IL-10), IL-12, and interferon-γ (IFN-γ) were detected by enzyme-linked immunosorbent assay. The apoptosis rate was evaluated via flow cytometry. The tumor volume and tumor growth inhibition rate (TGIR) were calculated on day 14. Tumor metabolism was assessed via 18F-FDG micropositron emission tomography/computer tomography. Results The tumor volume reduced by 22.0% and TGIR increased by 92.2% (p < 0.05) in the SBHFRT group. Further, on days 7 and 14 after radiation, tumor metabolism, Ki-67+ and Foxp3+ expression levels, and IL-10 levels were lower, and tumor necrosis and apoptosis rates; CD86+, CD4+, and CD8+ expression levels; and IL-12 and IFN-γ levels were higher in the SBHFRT group than in the CFRT group, particularly on day 7. Conclusion SBHFRT could lead to more accumulation of dendritic cells, anti-tumor lymphocytes, and cytokines, and further reduce the aggregation of immunosuppressive lymphocytes and cytokines in the tumor microenvironment compared with CFRT, and the difference was the most obvious on day 7 after radiation. The clinical significance of the findings remains to be further verified.

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“…transformed from conventional fraction radiotherapy (CFRT) to hypofractionated radiotherapy, now considered to be a new and highly effective mode of radiation therapy [1,2]. Stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery are common procedures in hypofractionated radiotherapy, especially SBRT, which is widely performed for lung cancer, colorectal cancer, liver cancer, and prostate cancer, and shows considerable improvement in the radiotherapeutic outcomes [3,4,5,6,7,8] Immunotherapy has recently emerged as a highly effective and novel therapeutic modality, which is now gaining popularity worldwide in cancer therapy [9]. Immunocheckpoint inhibitors, such as pembrolizumab and ipilimumab, are widely used for melanoma, NSCLC, and pancreatic cancer [10,11,12,13].…”

mentioning

confidence: 99%

Relationship Between the Invasion of Lymphocytes and Cytokines in the Tumor Microenvironment and the Interval After Single Brachytherapy Hypofractionated Rradiotherapy and Conventional Fractionation Radiotherapy in Non-Small Cell Lung Cancer

Lin

Yue

Han

et al. 2020

Preprint

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Background Lymphocytes and cytokines in tumor microenvironment are the key to immunotherapy, The effect of brachytherapy on tumor microenvironment is not clear. The aim of our study was to analyze the relationship between the invasion of lymphocytes and cytokines in the tumor microenvironment and the interval after single brachytherapy hypofractionated radiotherapy (SBHFRT) and conventional fractionation radiotherapy (CFRT) in non-small cell lung cancer (NSCLC). Methods Lewis tumor-bearing mice were randomly divided into control, CFRT and SBHFRT groups. On the days 7 and 14 after radiation, the expression rates of CD4+, CD8+, Foxp3+, and CD86 + cells and levels of Ki-67 + protein were detected by immunohistochemical analysis, and the tumor necrosis rate was calculated. Following this, interleukin-10 (IL-10), IL-12, and interferon-γ (INF-γ) levels were detected by enzyme-linked immunosorbent assay. The apoptosis rate was evaluated via flow cytometry. The tumor volume and tumor growth inhibition rate (TGIR) were calculated on day 14. Tumor metabolism was assessed via micro 18F-FDG positron emission tomography/computer tomography. Results The tumor volume in the SBHFRT group reduced by 22.0% and TGIR increased by 92.2% (P < 0.05). Further, on days 7 and 14 after radiation, tumor metabolism, Ki-67 + and Foxp3 + expression rates, and IL-10 levels were lower and tumor necrosis and apoptosis rates; CD86+, CD4+, and CD8 + expression rates; and IL-12 and INF-γ levels were higher in SBHFRT group than in the CFRT group, particularly on day 7. Conclusion SBHFRT could lead to more accumulation of dendritic cells and anti-tumor lymphocytes and cytokines in the tumor tissue, and further reduce the aggregation of immunosuppressive lymphocytes and cytokines in the tumor tissue compared with CFRT, and the difference was the most obvious was day 7 after radiation. Hypofractionated radiotherapy combined with immunotherapy may be better for treating NSCLC, as observed on day 7 after radiation.

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Outcomes of extra-cranial stereotactic body radiotherapy for metastatic colorectal cancer: Dose and site of metastases matter

Cited by 33 publications

References 25 publications

Outcomes of Stereotactic Body Radiotherapy for Metastatic Colorectal Cancer With Oligometastases, Oligoprogression, or Local Control of Dominant Tumors

Outcomes of Stereotactic Body Radiotherapy for Metastatic Colorectal Cancer With Oligometastases, Oligoprogression, or Local Control of Dominant Tumors

Relationship between the invasion of lymphocytes and cytokines in the tumor microenvironment and the interval after single brachytherapy hypofractionated radiotherapy and conventional fractionation radiotherapy in non-small cell lung Cancer

Relationship Between the Invasion of Lymphocytes and Cytokines in the Tumor Microenvironment and the Interval After Single Brachytherapy Hypofractionated Rradiotherapy and Conventional Fractionation Radiotherapy in Non-Small Cell Lung Cancer

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