Radiosensitizing Chemotherapy (Irinotecan) with Stereotactic Body Radiation Therapy for the Treatment of Inoperable Liver and/or Lung Metastases of Colorectal Cancer

• Published in: Cancers Vol. 13; no. 2; p. 248
• Main Authors: Vaugier, Loïg, Mirabel, Xavier, Martel-Lafay, Isabelle, Racadot, Séverine, Carrie, Christian, Vendrely, Véronique, Mahé, Marc-André, Senellart, Hélène, Raoul, Jean-Luc, Campion, Loïc, Rio, Emmanuel
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 11-01-2021; MDPI
• Subjects: Ablation; Cancer; Cell cycle; Chemotherapy; Colorectal cancer; Colorectal carcinoma; Hypotheses; Intravenous administration; Irinotecan; Life Sciences; Liver; Lung cancer; Metastases; Metastasis; Patients; Quality of life; Radiation therapy; Statistical analysis; colorectal cancer; irinotecan; stereotactic radiotherapy; lung metastases; oligometastases; liver metastases
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers13020248

: Stereotactic body radiotherapy (SBRT) is a recognized treatment for colorectal cancer (CRC) metastases. We postulated that local responses could be improved by SBRT with a concomitant radiosensitizing agent (irinotecan).
: RADIOSTEREO-CAMPTO was a prospective multi-center phase 2 trial investigating SBRT (40-48 Gy in 4 fractions) for liver and/or lung inoperable CRC oligometastases (≤3), combined with two weekly intravenous infusions of 40 mg/m
Irinotecan. Primary outcome was the objective local response rate as per RECIST. Secondary outcomes were early and late toxicities, EORTC QLQ-C30 quality of life, local control and overall survival.
: Forty-four patients with 51 lesions (liver = 39, lungs = 12) were included. Median age was 69 years (46-84); 37 patients (84%) had received at least two prior chemotherapy treatments. Median follow-up was 48.9 months. One patient with two lung lesions was lost during follow-up. Assuming maximum bias hypothesis, the objective local response rate in ITT was 86.3% (44/51-95% CI: [76.8-95.7]) or 82.4% (42/51-95% CI: [71.9-92.8]). The observed local response rate was 85.7% (42/49-95% CI: [75.9-95.5]). The 1 and 2-year local (distant) progression-free survivals were 84.2% (38.4%) and 67.4% (21.3%), respectively. The 1 and 2-year overall survivals were 97.5% and 75.5%. There were no severe acute or late reactions. The EORTC questionnaire scores did not significantly worsen during or after treatment.
: SBRT with irinotecan was well tolerated with promising results despite heavily pretreated patients.