Abstract
The purpose of this study was to investigate whether whole-liver radiotherapy plus a tumor-boost dose with concurrent chemotherapy is beneficial for colorectal cancer patients with massive and multiple liver metastases. From January 2007 to December 2012, 19 patients who exhibited massive (with a longest diameter > 5 cm) and invasive liver metastases and multiple metastases were treated with radiotherapy and concurrent chemotherapy. The total radiation dose was 53.4 Gy (range 38.8 Gy-66.3 Gy). All of the patients received a continuous intravenous dose of 5 fluorouracil (5-FU) 225 mg/m2 concurrently with radiation. The median survival time was 19 months. The 1- and 2- year overall survival rates were 78.3% and 14.3%, respectively. Of all of the patients who presented with abdominal pain, 100% experienced a decrease in pain. Decreases in the rates of ascites and jaundice were confirmed by ultrasound and bilirubin levels. No cases of Grade 4 or 5 acute or late toxicity were recorded. There were only two cases of Grade 3 toxicity (elevated bilirubin). These data provide evidence that whole-liver radiotherapy plus a tumor-boost dose with concurrent chemotherapy is beneficial for colorectal cancer patients with massive and multiple liver metastases.
Highlights
Liver metastases are one of the most common metastatic tumors, especially in colorectal cancer cases (Chong et al, 2013)
The purpose of this study was to investigate whether whole-liver radiotherapy plus a tumor-boost dose with concurrent chemotherapy is beneficial for colorectal cancer patients with massive and multiple liver metastases
We reported the results of colorectal patients with massive liver metastases that were treated using a tumor-boost dose to partial liver volumes beyond the typical to 30 Gy that is delivered to the whole-liver with concurrent chemotherapy
Summary
Liver metastases are one of the most common metastatic tumors, especially in colorectal cancer cases (Chong et al, 2013). The increased use of imaging has improved the detection of liver metastases. Fewer than 25% of patients can tolerate the surgery because of poor performance status, and these patients often have extra-liver metastases or refuse surgery for other reasons (Nordlinger et al, 2002; Lochan et al, 2007), and two-thirds of patients who undergo surgery relapse within 2 years (Malik et al, 2007). Systemic chemotherapy is the standard treatment for these patients. Most of these are at in the final stage, and there are multiple metastatic tumors in their liver (Timmerman et al, 2009). Most of them have severe hepatic dysfunction or metastatic hepatic lesions that they have become refractory to chemotherapy (Krishnan et al, 2006)
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