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Abstract
Our patient is a 48-year-old gentleman who initially was diagnosed with stage IV colorectal cancer on presentation. He had a history of multiple lines of systemic therapy, primary local resection, radioembolization treatments to the liver, along with liver metastasectomy with intraoperative radiofrequency ablation. He initially presented and completed single-isocenter stereotactic body radiation therapy (SBRT) to five right lung metastases with a treatment response and then completed SBRT to two additional right lower lung metastases. Since completion of his SBRT, he has remained disease free. Integration of SBRT to multiple ipsilateral lung lesions achieved a complete clinical response and assisted in keeping him disease free with the support of systemic therapy, and thus improved quality of life.
Highlights
Growing evidence has shown radiation treatment to oligometastatic sites can improve progression-free survival (PFS) and suggests an improvement in overall survival (OS) [1]
A recent National Surgical Adjuvant Breast and Bowel Project, Radiation Therapy Oncology Group, Gynecologic Oncology Group (NRG) study began in hopes of determining the safety and efficacy of Stereotactic body radiation therapy (SBRT) treatment to four or less metastatic lesions [2]
We present a case of a gentlemen who had five right lung lesions treated synchronously followed by two additional right lung lesions treated synchronously, to a total of seven lesions treated with SBRT in the same lung, less than 5 cm apart from each other
Summary
Growing evidence has shown radiation treatment to oligometastatic sites can improve progression-free survival (PFS) and suggests an improvement in overall survival (OS) [1]. SBRT, stereotactic body radiation therapy; PTV, planning target volume. His chest CT scan done eight weeks later showed a decrease in the right lung nodules. The post-treatment scan done one month after showed a decrease in the right lower lung nodules, and subsequent CT scans showed resolution of all pulmonary nodules with post-radiation changes. He was eventually placed back on systemic therapy 11 days later. His most recent restaging chest, abdomen, and pelvic CT scans done 14 months later showed no evidence of metastatic disease.
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