Denis RomanovCenter of Innovative Medical Technologies, Russia Federation
Title: Stereotactic body radiation therapy for colorectal cancer liver metastases
Methods: The study included 115 patients with CRC liver metastases. The vast majority of patients had a long-term history of the disease: 73 had 1-4 liver resections (41 – hemihepatectomy); the median number of chemotherapy regimens was 3. In 19 patients, SBRT was performed in combination with simultaneous chemotherapy or chemo-targeted therapy. A total of 182 metastases with a median size of 18 mm and a mean of 23 mm were treated with SBRT. Total doses were: 30-45 Gy for 85 (“low dose” cohort), 51-60 Gy for 97 (“high dose” cohort). All patients were treated in 3 fractions, and almost all – over 3-8 days.
Results: Only one patient had an acute radiation reaction, which led to an increase in the duration of the SBRT course to 24 days. Of the late adverse events, 3 cases of gastric ulcer development were recorded, 2 – of subcutaneous fat fibrosis, 1 – of intercostal neuralgia, hydrothorax, rib fracture and vertebral corpus fracture; 2 cases of development of acute esophagitis, 1 – gastritis and 1 – cholecystitis were also noted, stopped by medication. Median overall survival (OS) after SBRT was 41,1 months (24,8-57,4); in group with now metastases except those exposed to radiation – 54 months (35,4-73,5) with no “active” – 31,1, with “active” – 20,9 (15,6-26,2). Median of the local control score wasn’t reached in all groups but it was significantly better in “high dose” than “low” (p=0.0001) and in the 45Gy-group than 30-36Gy (p=0.0001). In the “low dose” group, LC was significantly higher for those metastases that were subjected to SBRT at the time of being controlled by antitumor treatment (N=19) compared with those who did not respond to previous treatment or if their treatment was started with SBRT (N=66) (p = 0.033) (such results contradict the conclusions of a number of retrospective studies but seem logical).
Denis Romanov completed his PhD at the age of 32 years from N.N. Blokhin’s National Medical Scientific Center of Oncology, Russian Federation. He is the head of the Scientific activity department of LCC “Center of Innovative Medical Technologies” since 2019 and head of the Radiation Oncology department of Central Clinical Hospital of Russian Railways since 2020. He has 69 publications in Russian and foreign medical magazines and 63 oral presentations