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Session Item

Saturday
August 28
10:30 - 11:30
Online Stream 2
Poster Highlights 4: Lower GI (colon, rectum, anus)
Florence Huguet, France
Poster highlights
Clinical
10:46 - 10:54
Multicenter large retrospectIve database on SBRT for colorectal lung metastases: the LaIT-SABR study
Luca Nicosia, Italy
PH-0112

Abstract

Multicenter large retrospectIve database on SBRT for colorectal lung metastases: the LaIT-SABR study
Authors:

Luca Nicosia1, Davide Franceschini2, Francesca Perrone Congedi3, Franco Casamassima4, Marianna Alessandra Gerardi5, Marco Perna6, Vieri Scotti6, Andrei Fodor7, Rosario Mazzola1, Michele Rigo1, Aurelia Iurato8, Francesco Pasqualetti9, Giovanni Gadducci9, Silvia Chiesa10, Rita Marina Niespolo11, Alessio Bruni12, Luca Frassinelli12, Paolo Borghetti13, Alessandro Di Marzo14, Andrea Ravasio15, Berardino De Bari16,17, Matteo Sepulcri18, Dario Aiello19, Gianluca Mortellaro20, Claudia Sangalli21, Marzia Franceschini21, Giampaolo Montesi22, Francesco Maria Aquilanti23, Riccardo Valdagni21, Ivan Fazio19, Luigi Corti18, Luigi Vavassori15, Ernesto Maranzano14, Stefano Maria Magrini13, Frank Lohr12, Stefano Arcangeli11, Vincenzo Valentini24,25, Fabiola Paiar9, Sara Ramella8, Nadia Gisella Di Muzio7,26, Lorenzo Livi6, Barbara Alicja Jereczek-Fossa27, Barbara Alicja Jereczek-Fossa28, Mattia Falchetto Osti3, Marta Scorsetti2, Filippo Alongi1,29

1IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Advanced Radiation Oncology Department, Negrar, Italy; 2IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Department of Radiotherapy and Radiosurgery, Milan, Italy; 3"Sapienza" University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189, Department of Radiation Oncology, Rome, Italy; 4Ecomedica, Ecomedica Radioterapia, Empoli, Italy; 5European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132, Division of Radiation Oncology, IEO, Milan, Italy; 6Azienda Ospedaliera Universitaria Careggi, University of Florence, Radiation Oncology Unit, Florence, Italy; 7IRCCS San Raffaele Scientific Institute, Department of Radiation Oncology, Milan, Italy; 8Campus Bio-Medico University, Via A. del Portillo, 21, 00128, Radiation Oncology, Rome, Italy; 9Pisa University Hospital, Via Roma 67, 56123, Radiation Oncology Unit, Pisa, Italy; 10Divisione di Radioterapia Oncologica - Gemelli ART, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy; 11Azienda Ospedaliera S. Gerardo, Department of Radiation Oncology, Monza, Italy; 12University Hospital of Modena, Radiation Therapy Unit, Modena, Italy; 13ASST Spedali Civili di Brescia - Brescia University, Radiation Oncology Department, Brescia, Italy; 14S. Maria Hospital, Radiation Oncology Centre, Terni, Italy; 15Humanitas Gavazzeni, 24125, Department of Radiation Oncology, Bergamo, Italy; 16University Hospital "Jean Minjoz", Department of Radiation Oncology, Besançon, France; 17University of Lausanne (UniL), Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; 18Veneto Institute of Oncology IOV-IRCCS, Radiation Oncology Unit, Padua, Italy; 19Casa di Cura Macchiarella, Radiotherapy Unit, Palermo, Italy; 20ARNAS Ospedale Civico, Department of Radiation Oncology, Palermo, Italy; 21Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Radiation Oncology 1, Milan, Italy; 22ULSS5, Radiotherapy Unit, Rovigo, Italy; 23Marrelli Hospital, Radiotherapy Marrelli Hospital, Crotone, Italy; 24Fondazione Policlinico Universitario A.Gemelli IRCCS, Divisione di Radioterapia Oncologica - Gemelli ART, Rome, Rome, Italy; 25Università Cattolica del Sacro Cuore, -, Rome, Italy; 26Vita-Salute San Raffaele University, -, Milan, Italy; 27IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132, Division of Radiation Oncology, Milan, Italy; 28University of Milan, Via Festa del Perdono, 7, 20122 , Department of Oncology and Hemato-oncology, Milan, Italy; 29University of Brescia, -, Brescia, Italy

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Purpose or Objective

stereotactic ablative radiotherapy (SABR) has been shown to increase survival rates in oligometastatic disease (OMD), but local control of colorectal metastases still remains poor. We aimed to identify potential predictive factors of SABR response through a multicenter large retrospective database and to investigate how lung SABR can impact on the progression to the polymetastatic disease.

Material and Methods

the study involved 22 centers, and was approved by the Ethical Committee (Prot. Negrar 2019-ZT). 1023 lung metastases treated with SABR in 622 patients were reported. The median biological equivalent dose (BED) was 105 Gy10. Lesion diameter GTV, PTV volume, dose, fractionations, and site of primary tumor were evaluated as potential predictive marker for SABR response for the primary end-point local progression-free survival (LPFS). EGFR, KRAS, NRAS, BRAF, and MSI were also evaluated. Secondary end-point was the time to the polymetastatic conversion (ttPMC).

Results

the median follow-up was 26 months (range 3-117 months). The median lesion diameter was 13 mm (range 4-58 mm). The 2- and 3-year LPFS were 75.6% and 71%, respectively. At the univariate analysis, BED ≥125Gy10 was associated with improved LPFS (2-year: 94.1% versus 72.6%; p= <0.0001), single fraction SABR correlated with better LPFS in the overall population (2-year: 80.6% versus 73.7%; p=0.03), but no significant difference was observed when considering the population treated with BED>100 Gy10. Lesion diameter ≤19 mm correlated with improved LPFS (2-year 80% versus 60%; p=<0.0001). The median ttPMC was 26 months, and the 2-year ttPMC was 54.5%. The median PFS was 11.3 months. After SABR, 36% patients had polymetastatic relapse, 39.5% patients had further oligometastatic relapse, and 24.5% patients had no relapse at all.

Conclusion

The present is the largest series of lung colorectal metastases treated with SABR. The results support the use of SBRT in lung oligometastatic colorectal cancer patients as it might delay the transition to polymetastatic disease or offer relatively long disease-free period in selected cases. Several biological and clinical predictive factors were identified to assure the highest local control, on the basis of which a decisional algorithm will be derived.