Stereotactic body radiotherapy vs surgery in solitary colorectal cancer metastastases

Introduction. The standard of treatment for solitary metastases of colorectal cancer in the liver is a combination of liver resection and polychemotherapy. If surgery is not possible, stereotactic radiotherapy (SBRT) may be used.

The purpose of the study. To evaluate the results of SBRT and liver resection in patients with solitary metastases of colon cancer in the liver.

Materials and methods of research. Local control (LC), overall survival (OS), and progression-free survival (PFS), and the incidence of complications in the liver resection (n = 32) and SBRT (n = 26) groups were retrospectively assessed. The median dose was 54 Gy into 3 factions.

Results. Median follow-up - 33.6 months. in the SBRT group and 30,5 months in the surgery group (p>0,05). No grade 3 toxicity was noted. Three-year LC in the CRT group reached 64,2 % (95 % CI = 46–89,6 %) and 72,8 % (95 % CI = 56,7–93,6 %) in the surgery group (p = 0,53), the median LC has not been reached. Three-year OS in the SBRT group was 67,9 % (95 % CI = 50,8–90,7 %) and 64,4 % (95 % CI = 44,5–93,2 %) in the surgical group (p = 0,85). The 3-year PFS for SBRT was 5,8 % with a median of 9,2 months and 15,6 % in the surgery group with a median of 16,5 months (p=0,44). There were no statistically significant differences between SBRT and liver resection in LC and OS.

Conclusion. For solitary metastases of colon cancer in the liver, SBRT can provide results comparable to those of surgical treatment.

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