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Published on: May 8, 2018
Stereotactic body radiotherapy for isolated paraaortic lymph node recurrence from colorectal cancer
Mi-Sook Kim1, Chul Koo Cho, Kwang Mo Yang
1Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 215-4 Gongneung-dong, Nowon-gu, Seoul 139-706, South Korea. mskim@kcch.re.kr
Aim:
To evaluate the efficacy and complications of stereotactic body radiotherapy in localized paraaortic lymph node recurrence from colorectal cancer.
Methods:
From 2003 to 2009, 7 patients with paraaortic lymph node recurrence (1-3 lesions) from colorectal cancer were treated with stereotactic body radiotherapy. Total gross tumor volumes ranged from 4 to 40 mL. The doses were escalated from 36 Gy/patient to 51 Gy/patient and were delivered in 3 fractions.
Results:
One and 3 year overall survival rates were 100% and 71.4%, respectively, and median survival was 37 mo. Grade IV intestinal obstruction was reported in 1 of 7 patients. This patient received 48 Gy in 3 fractions with a maximum point dose to the intestine of 53 Gy and V(45Gy) = 3.6 mL. However, 6 patients received an intestinal maximum point dose of < 51 Gy and V(45Gy) of < 1 mL, and did not develop any severe complications.
Conclusion:
This pilot study suggests selected paraaortic lymph node recurrence (1-3 closed lesions) that failed to respond to chemotherapy can be potentially salvaged by stereotactic body radiotherapy.
