Möglichkeiten der lokal-ablativen Bestrahlung (SBRT) bei metastasiertem kolorektalem Karzinom

BACKGROUND: Colorectal cancer (CRC) often presents as oligometastatic disease. Currently available intensive systemic treatment regimens, including combination chemotherapy and molecular targeted agents, result in tumor response and transient to long-term disease control in a high percentage of patients, thus raising the question of further management. Secondary resection and ablation, e.g. by surgery or radiofrequency may contribute to long-term survival and even be curative or at least allow a relevant chemotherapy-free interval. These approaches are often limited by the anatomical site, invasiveness and morbidity of the respective procedure. With stereotactic body radiotherapy (SBRT) metastases can be treated with very high efficiency in only a few sessions and achieving long-term control.

OBJECTIVES: Identification of clinical studies investigating the use of SBRT for treatment of oligometastases in CRC patients. Control rates in liver and lung metastases and survival after SBRT. Toxicity and side effects of the treatment.

MATERIAL AND METHODS: A literature search was carried out for prospective and retrospective studies on local SBRT.

RESULTS AND CONCLUSION: The SBRT procedure has become a valid treatment option for patients with oligometastatic CRC and should also be considered in clinical practice as an alternative to surgical treatment of metastases or other local ablative techniques.