SBRT for Colorectal Cancer Liver Metastasis Is a Safe and Effective Treatment Option-A Single Institution Retrospective Analysis.

BACKGROUND

Colorectal cancer is the third most commonly diagnosed cancer in the world. Liver metastases are frequent, adversely affecting patient prognosis. We compared progression-free survival and overall survival in colorectal cancer patients with liver metastasis treated with surgical resection or stereotactic body radiotherapy. No previous study had shown superiority of one treatment option over the other.

METHODS

We conducted a retrospective cohort study of 40 colorectal cancer patients with liver metastasis treated with surgical resection or stereotactic body radiotherapy at the Hebrew University-Hadassah Medical Center. Patient demographics, tumor characteristics, treatment details, and survival outcomes were analyzed. Kaplan-Meier curves and log-rank tests were used for survival analysis.

RESULTS

The median overall survival for the entire cohort was 44 months (95% CI 29-59 months). In patients treated with surgical resection, the median overall survival was 51 months (95% CI: 36-67 months), while in patients treated with stereotactic body radiotherapy the median overall survival was 32 months (95% CI: 21-43 months), a non-statistically significant result (p = 0.306). The number of lobes involved did not significantly impact overall survival (p = 0.214). Additionally, it did not significantly affect progression-free survival (p = 0.41). Liver metastases located in the left lobe led to considerably worse progression-free survival compared to other regions involved, specifically in the patients who underwent surgery.

CONCLUSIONS

Our findings underscore the importance of personalized treatment strategies tailored to the distinct characteristics of colorectal cancer patients with liver metastasis. Currently, surgical resection remains the standard of care. Further research is warranted to address the possibility of extending SBRT to first-line treatment in selected unresectable patients.