Carbon ion radiotherapy for oligo-recurrent lung metastases from colorectal cancer: a feasibility study

Radiation Oncology

Tadashi Kamada²  Hiroshi Tsuji²  Keiichi Nakagawa¹  Hideomi Yamashita¹  Shigeru Yamada²  Naoyoshi Yamamoto²  Mio Nakajima²  Wataru Takahashi¹ 

[1] Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan

关键词: Toxicity;    Survival;    Local control;    Oligometastases;    Prognosis;    Lung metastases;    Colorectal cancer;    Carbon ion radiotherapy;   

Others  :  811769
DOI  :  10.1186/1748-717X-9-68

 received in 2013-08-25, accepted in 2014-02-20,  发布年份 2014

【 摘 要 】

Background

The purpose of this study was to evaluate the efficacy and feasibility of carbon ion radiotherapy (CIRT) for oligo-recurrent lung tumors from colorectal cancer (CRC).

Methods

From May 1997 to October 2012, 34 consecutive patients with oligo-recurrent pulmonary metastases from CRC were treated with CIRT. The patients were not surgical candidates for medical reasons or patient refusal. Using a respiratory-gated technique, carbon ion therapy was delivered with curative intent using 4 coplanar beam angles. A median dose of 60 GyE (range, 44–64.8 GyE) was delivered to the planning target volume (PTV), with a median daily dose of 15 GyE (range, 3.6–44 GyE). Treatment outcome was analyzed in terms of local control rate (LCR), survival rate, and treatment-related complications.

Results

In total, 34 patients with 44 oligo-recurrent pulmonary lesions were treated with CIRT. Median follow-up period was 23.7 months. The 2- and 3-year actuarial LCRs of the treated patients were 85.4% ± 6.2% and 85.4% ± 6.2%, respectively. Overall survival was 65.1% ± 9.5% at 2 years, and 50.1% ± 10.5% at 3 years. Although survival rates were relatively worse in the subsets of patients aged < 63 years or with early metastasis (< 36 months after resection of primary site), these factors were not significantly correlated with overall survival (P = 0.13 and 0.19, respectively). All treatment-related complications were self-limited, without any grade 3–5 toxicity.

Conclusions

CIRT is one of the most effective nonsurgical treatments for colorectal lung metastases, which are relatively resistant to stereotactic body radiotherapy. CIRT is considered to be the least invasive approach even in patients who have undergone repeated prior thoracic metastasectomies.

【 授权许可】

   
2014 Takahashi et al.; licensee BioMed Central Ltd.

【 图 表 】

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