Medical Radiology and Radiation Safety. 2014. Vol. 59. No. 5. P. 32-36
RADIATION THERAPY
O.K. Kurpeshev1, N.Yu. Florovskaiya2
Outcomes of External Beam Radiation Therapy for Colorectal Cancer Liver Metastases
1. Medical Radiological Research Center, Obninsk, Kaluga region, Russia. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. Murmansk Regional Oncology Dispanser, Murmansk, Russia
ABSTRACT
Purpose: To evaluate the efficacy of external beam radiation therapy with 2D planning (2D-EBRT) for colorectal cancer liver metastases (MTS).
Material and methods: 2D-EBRT was performed in 28 patients with clinically chemoresistant forms of MTS. The age of patients fluctuated from 26 to 77 years (mean age 62.3 years). There were 16 (57 %) men and 12 (43 %) women. The control group consisted of 76 patients who received symptomatic treatment only. EBRT was given using two opposed fields and a fractionation schedule of 1.8 to 2 Gy per day, five days a week. Total tumor dose (TTD) to a solitary MTS or one lobe were 26–36 Gy, and 20–26 Gy for the whole liver. Treatment outcomes were judged by the degree of liver involvement.
Results: Immediate MTS response to EBRT resulted in partial tumor response in 14 % of patients and into desiase’s stabilization in 32 % of patients. Partial response was achieved after radiation therapy with a TTD of 30–36 Gy delivered to tumors sized up to 4 cm. In some patients, therapy yielded benefit, such as improvements in general health status, disease symptoms and liver function test results. Radiation-induced skin reactions at irradiation of one liver lobe with a TTD of 30–36 Gy caused moderate or marked erythema (2–3 degrees), as well as dry desquamation in some cases. Expressed radiation hepatitis developed in 2 patients. There was no statistically significant difference in overall survival between the EBRT and control groups.
Conclusion: At patients with chemoresistant MTS of a colorectal cancer in a liver 2D-EBRT increases quality of life which is shown by improvement of the general status and disease symptomatology.
Key words: radiation therapy, colorectal cancer, liver metastases