ESTRO 2024 - Abstract Book

S102

Invited Speaker

ESTRO 2024

Abstract:

In the evolving landscape of oncological treatments, Stereotactic Body Radiation Therapy (SBRT) has emerged as an important ablative modality, for different kind of tumors, including patients with oligometastatic colorectal cancer. The presentation will discuss the strategic implementation of SBRT in this setting, addressing the critical questions of “when” and “what”: when to consider SBRT as a viable treatment option, and what protocols to follow to improve patient outcomes. Oligometastatic disease, characterized by a limited number of metastases, often presents as a unique therapeutic window and a distinct clinical scenario, where local interventions can significantly improve disease control and patient’s quality of life. Colorectal cancer, as the third most common cancer worldwide, frequently leads to isolated metastatic disease, with liver and lung being the most common sites of metastasis. We will explore the outcomes of SBRT in this patient population, including local control rates, overall survival, and safety of the treatment. The presentation will discuss the criteria for selecting patients who will benefit the most from SBRT, emphasizing the importance of clinical factors, demonstrated by recent literature to influence treatment response, such as the number, size or volume of metastases, the patient's overall health status, and the timing and type of oligometastatic presentation. A significant focus will be also on the optimal timing of SBRT. Evidence demonstrated that early local intervention may be potentially crucial for an optimal outcome, yet the decision must be carefully weighed against the potential for associated risks. We will outline the results of studies and ongoing research that support the timing and sequencing of SBRT in the modern treatment regimen for oligometastatic colorectal cancer. Guckenberger M, Lievens Y, Bouma AB, Collette L, Dekker A, deSouza NM, Dingemans AC, Fournier B, Hurkmans C, Lecouvet FE, Meattini I, Méndez Romero A, Ricardi U, Russell NS, Schanne DH, Scorsetti M, Tombal B, Verellen D, Verfaillie C, Ost P. Characterisation and classification of oligometastatic disease: a European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus recommendation. Lancet Oncol. 2020 Jan;21(1):e18-e28. doi:10.1016/S1470-2045(19)30718-1. PMID: 31908301. Cervantes A, Adam R, Roselló S, Arnold D, Normanno N, Taïeb J, Seligmann J, De Baere T, Osterlund P, Yoshino T, Martinelli E; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2023 Jan;34(1):10-32. doi: 10.1016/j.annonc.2022.10.003. Epub 2022 Oct 25. PMID: 36307056. Harrow S, Palma DA, Olson R, Gaede S, Louie AV, Haasbeek C, Mulroy L, Lock M, Rodrigues GB, Yaremko BP, Schellenberg D, Ahmad B, Senthi S, Swaminath A, Kopek N, Liu M, Schlijper R, Bauman GS, Laba J, Qu XM, Warner A, Senan S. Stereotactic Radiation for the Comprehensive Treatment of Oligometastases (SABR-COMET): Extended Long-Term Outcomes. Int J Radiat Oncol Biol Phys. 2022 Nov 15;114(4):611-616. doi:10.1016/j.ijrobp.2022.05.004. Epub 2022 May 26. PMID: 35643253. Ruers T, Van Coevorden F, Punt CJ, Pierie JE, Borel-Rinkes I, Ledermann JA, Poston G, Bechstein W, Lentz MA, Mauer M, Folprecht G, Van Cutsem E, Ducreux M, Nordlinger B; European Organisation for Research and Treatment of Cancer (EORTC); Gastro-Intestinal Tract Cancer Group; Arbeitsgruppe Lebermetastasen und tumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO); National Cancer Research Institute Colorectal Clinical Study Group (NCRI CCSG). Local Treatment of Unresectable Colorectal Liver Metastases: Results of a Randomized Phase II Trial. J Natl Cancer Inst. 2017 Sep 1;109(9):djx015. doi: 10.1093/jnci/djx015. PMID: 28376151; PMCID: PMC5408999. Nicosia L, Franceschini D, Perrone-Congedi F, Casamassima F, Gerardi MA, Rigo M, Mazzola R, Perna M, Scotti V, Fodor A, Iurato A, Pasqualetti F, Gadducci G, Chiesa S, Niespolo RM, Bruni A, Alicino G, Frassinelli L, Borghetti P, Di Marzo A, Ravasio A, De Bari B, Sepulcri M, Aiello D, Mortellaro G, Sangalli C, Franceschini M, Montesi G, Aquilanti FM, Lunardi G, Valdagni R, Fazio I, Scarzello G, Corti L, Vavassori V, Maranzano E, Magrini SM, Arcangeli S, Gambacorta MA, Valentini V, Paiar F, Ramella S, Di Muzio NG, Livi L, Jereczek-Fossa BA, Osti MF, Scorsetti M, Alongi F. A multicenter LArge retrospectIve daTabase on the