A Concise Review of Pelvic Radiation Therapy (RT) for Rectal Cancer with Synchronous Liver Metastases

Table 1

Selected series incorporating pelvic RT in multimodality management of stage IV rectal cancer with liver metastases (with or without other distant metastases) as a palliative therapeutic strategy.

Authors (Reference)	Study year	Study design	Number of patients	Disease status	RT dose and fractionation	Median follow-up (range)	Response to palliative RT
Crane et al. [85]	2001	Retrospective	80	Stage IV rectal cancer with synchronous distant metastases	30 Gy/6 fx (50%); 45 Gy/25 fx (16%); 35 Gy/14 fx (14%); Other (20%)	52 (3-444) weeks	Symptoms due to rectal tumor resolved in 94%; Overall 1-year actuarial symptom control rate 85%; Overall 2-year actuarial symptom control rate 82%
Bae et al. [86]	2011	Retrospective	80	Metastatic stage IV colorectal cancer	Median total RT dose 36 Gy (range: 8-60 Gy); Median dose per fraction 2.5 Gy (range: 1.8-8 Gy)	5 (1-44) months	Overall symptomatic palliation rate 80%; Median symptom control duration 5 months (range: 1-44 months)
Tyc-Szczepaniak et al. [87]	2013	Prospective phase II study	40	Stage IV rectal cancer with synchronous distant metastases	25 Gy/5 fx (97.5%); 30 Gy/6 fx (2.5%)	26 (19-34) months	Complete resolution of pelvic symptoms during the whole course of disease in 12 patients (30%); Significant improvement in 14 patients (35%); 67% probability of a sustained good palliative effect at 2 years
Picardi et al. [72]	2016	Prospective phase II study	18	Stage IV rectal cancer with synchronous distant metastases	25 Gy/5 fx	11.5 (3-36) months	Complete response (i.e., complete resolution of symptoms) at 4 weeks after treatment in 7 patients (38.9%); Partial response at 4 weeks after treatment in 9 patients (50%); Reduction or resolution of pain 87.5%; Reduction or resolution of bleeding 100%