Stereotactic body radiation therapy for colorectal liver metastases

Mohamad, Issa; Barry, Aisling; Dawson, Laura A.; Hosni, Ali

doi:10.1080/02656736.2021.1923836

Cited by 114 publications

(11 citation statements)

References 58 publications

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“…Compared to traditional normofractionated RT, SBRT allows for the precise delivery of possibly high ablative doses to liver metastases, sparing the uninvolved liver and surrounding critical structures as much as possible, to reduce the risk of RT-induced liver disease [ 72 ]. It is generally performed in 1–5 fractions [ 73 ], reducing overall treatment time to prevent treatment delays/interruptions of systemic therapy and to improve treatment response [ 68 ]. Based on the available data, hepatic SBRT should be evaluated for patients with oligometastatic, unresectable (for technical or medical reasons) CRLM, after failure of other local therapies and in combination with surgical resection.…”

Section: Locoregional Treatments Of Crlmsmentioning

confidence: 99%

“…Patients should have an ECOG performance status of ≤2, expected survival >3 months, >700 cc of uninvolved liver, ≤5 liver metastases, potentially curable extrahepatic disease, adequate liver function (no cirrhosis Child C), and dimensions of the tumoral lesion < 6 cm [ 74 ]. Finally, the rate of local control in patients with KRAS and/or TP53 mutation is relatively low (up to 20%) and this should be taken into consideration when choosing this approach [ 68 ].…”

Section: Locoregional Treatments Of Crlmsmentioning

confidence: 99%

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Multimodal Management of Colorectal Liver Metastases: State of the Art

Filoni,

Musci,

Di Rito

et al. 2024

Oncol Rev.

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Liver is the most common site of colorectal cancer (CRC) metastases. Treatment of CRC liver metastases (CRLM) includes different strategies, prevalently based on the clinical and oncological intent. Valid approaches in liver-limited or liver-prevalent disease include surgery, percutaneous ablative procedures (radiofrequency ablation, microwave ablation), intra-arterial perfusional techniques (chemo-embolization, radio-embolization) as well as stereotactic radiotherapy. Systemic treatments, including chemotherapy, immunotherapy and other biological agents, are the only options for patients with no chance of locoregional approaches. The use of chemotherapy in other settings, such as neoadjuvant, adjuvant or conversion therapy of CRLM, is commonly accepted in the clinical practice, although data from several clinical trials have been mostly inconclusive. The optimal integration of all these strategies, when applicable and clinically indicated, should be ever considered in patients affected by CRLM based on clinical evidence and multidisciplinary experience. Here we revised in detail all the possible therapeutic approaches of CRLM focusing on the current evidences, the studies still in progress and the often contradictory data.

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Section: Locoregional Treatments Of Crlmsmentioning

confidence: 99%

Section: Locoregional Treatments Of Crlmsmentioning

confidence: 99%

Multimodal Management of Colorectal Liver Metastases: State of the Art

Filoni,

Musci,

Di Rito

et al. 2024

Oncol Rev.

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“…Unlike RFA and MWA, the SBRT is the better technique to access the perihilar, periampullary, or subcapsular lesions ( 86 ). SBRT can be considered, in combination with surgical resection, for oligometastatic liver disease that failed local therapies ( 87 ). Candidates with ≤ 5 CRLM involving <700 cc of the liver, an expected survival of > 3 months, curative extrahepatic disease, no chemotherapy received before two weeks of planned SBRT, and ≤ 2 Eastern Cooperative Oncology Group performance status are suitable for SBRT ( 87 ).…”

Section: Therapies With Curative Intentmentioning

confidence: 99%

Interventional radiological therapies in colorectal hepatic metastases

Vulasala,

Sutphin,

Kethu

et al. 2023

Front. Oncol.

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Colorectal malignancy is the third most common cancer and one of the prevalent causes of death globally. Around 20-25% of patients present with metastases at the time of diagnosis, and 50-60% of patients develop metastases in due course of the disease. Liver, followed by lung and lymph nodes, are the most common sites of colorectal cancer metastases. In such patients, the 5-year survival rate is approximately 19.2%. Although surgical resection is the primary mode of managing colorectal cancer metastases, only 10-25% of patients are competent for curative therapy. Hepatic insufficiency may be the aftermath of extensive surgical hepatectomy. Hence formal assessment of future liver remnant volume (FLR) is imperative prior to surgery to prevent hepatic failure. The evolution of minimally invasive interventional radiological techniques has enhanced the treatment algorithm of patients with colorectal cancer metastases. Studies have demonstrated that these techniques may address the limitations of curative resection, such as insufficient FLR, bi-lobar disease, and patients at higher risk for surgery. This review focuses on curative and palliative role through procedures including portal vein embolization, radioembolization, and ablation. Alongside, we deliberate various studies on conventional chemoembolization and chemoembolization with irinotecan-loaded drug-eluting beads. The radioembolization with Yttrium-90 microspheres has evolved as salvage therapy in surgically unresectable and chemo-resistant metastases.

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“…Once metastasis has been identified, the commonly applied adjuvant treatments include chemotherapy, targeted therapy, and immunotherapy ( Figure 1 ). Also, radiation therapy presents a viable treatment option for CRC patients with oligometastasis in the liver and lungs ( Tam and Wu, 2019 ; Mohamad et al, 2022 ) For chemotherapy, the standard treatment regimen includes fluoropyrimidines (either intravenous fluorouracil (5-FU) or oral capecitabine) in combination with oxaliplatin (OX, DNA alkylating agent) or irinotecan (DNA topoisomerase I (TOP 1) inhibitor) (FOLFOX or CAPOX) or (FOLFIRI or CAPIRI) regimens, and a combination drug in a pill form called TAS-102 or Lonsurf (trifluridine and tipiracil) ( Prager et al, 2023 ). According to the current guidelines, the folic acid derivative, leucovorin together with 5-FU combined with oxaliplatin (FOLFOX) or 5-FU combined with irinotecan (FOLFIRI) are recommended as the first-line therapy for patients with mismatch repair proficient (pMMR), microsatellite stable (MSS) metastatic CRC (mCRC) ( Morris et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Deciphering treatment resistance in metastatic colorectal cancer: roles of drug transports, EGFR mutations, and HGF/c-MET signaling

Albadari,

Xie,

2024

Front. Pharmacol.

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In 2023, colorectal cancer (CRC) is the third most diagnosed malignancy and the third leading cause of cancer death worldwide. At the time of the initial visit, 20% of patients diagnosed with CRC have metastatic CRC (mCRC), and another 25% who present with localized disease will later develop metastases. Despite the improvement in response rates with various modulation strategies such as chemotherapy combined with targeted therapy, radiotherapy, and immunotherapy, the prognosis of mCRC is poor, with a 5-year survival rate of 14%, and the primary reason for treatment failure is believed to be the development of resistance to therapies. Herein, we provide an overview of the main mechanisms of resistance in mCRC and specifically highlight the role of drug transports, EGFR, and HGF/c-MET signaling pathway in mediating mCRC resistance, as well as discuss recent therapeutic approaches to reverse resistance caused by drug transports and resistance to anti-EGFR blockade caused by mutations in EGFR and alteration in HGF/c-MET signaling pathway.

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Stereotactic body radiation therapy for colorectal liver metastases

Cited by 114 publications

References 58 publications

Multimodal Management of Colorectal Liver Metastases: State of the Art

Multimodal Management of Colorectal Liver Metastases: State of the Art

Interventional radiological therapies in colorectal hepatic metastases

Deciphering treatment resistance in metastatic colorectal cancer: roles of drug transports, EGFR mutations, and HGF/c-MET signaling

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