|
| Authors (Reference) | Study year | Study design | Number of patients | Disease status | RT dose and fractionation | Median follow-up (range) | Response to RT |
|
| Shin et al. [73] | 2011 | Retrospective | 6 | Stage IV LARC with synchronous distant metastases | 25 Gy/5 fx | 16.7 (15.5-23.5) months | No local recurrence during follow-up period
R0 resection accomplished in 5 patients (84%) |
| Salgado et al. [74] | 2014 | Retrospective | 26 | Stage IV LARC with synchronous distant metastases | 45 ±5.4 Gy/25-28 fx | - | 1-year OS 95%
2-year OS 70%
Mean survival time 40.5 months
1-year PFS 91%
2-year PFS 36%
Mean PFS time 23.1 months
1-year LC 91%
2-year LC 66% |
| Yoon et al. [83] | 2016 | Retrospective | 50 | Stage IV LARC with synchronous distant metastases | 25 Gy/5 fx | 22 (9-59) months | Median PFS 16 months
2-year PFS 34.8%
2-year OS 73.9%
5-year OS 55.1% |
| Cho et al. [82] | 2016 | Prospective multicenter randomized phase 2 study | 38 | Stage IV rectal cancer with synchronous liver metastases | 45 ±5.4 Gy/25-28 fx | - | Overall R0 resection rate for both the primary tumor and liver metastases was 77.8% in arm A (induction CapeOx + CapeOx-RT) and 70% in arm B (CapeOx-RT alone)
Median PFS 14.2 months in arm A and 15.1 months in arm B
3-year OS 75% in arm A and 88.8% in arm B |
| Kim et al. [81] | 2016 | Prospective phase 2 study | 32 | Stage IV rectal cancer with synchronous liver metastases | 25 Gy/5 fx | - | Surgical resection of rectum and liver accomplished in 25 patients (78%)
R0 resection in 20 patients(63%)
Rectal tumor downstaging in 54% of patients
Median OS 38 months
Median PFS 9 months |
| Bird et al. [80] | 2017 | Retrospective | 78 | Stage IV rectal cancer with synchronous liver metastases | 50.4 Gy/28 fx (split course RT) | 6.2 years | Radiological complete or partial response for local disease 90%
Radiological complete or partial response for metastatic disease 66%
Median OS in patients having unresectable metastatic disease at baseline 23 (19-28) months
Estimated 3-year OS 62% for the 12 patients treated with radical surgery for both rectum and liver
For patients not receiving rectal surgery, palliative re-irradiation or surgery at a later date needed in only 7% |
| Fossum et al. [91] | 2017 | Retrospective | 93 | Stage IV rectal cancer with synchronous distant metastases | Median 50.4 Gy/28 fx for LCRT
Median 25 Gy/5 fx for SCRT (±intraoperative RT to median dose of 12.5 Gy) | 43 (16-67) months | LR was not observed in patients receiving neoadjuvant RT
12 patients (26%) receiving no RT had LR
Omission of neoadjuvant RT was associated with development of subsequent LR
5-year OS 43.3% for no RT group
5-year OS 58.3% for the RT group |
| Holliday et al. [76] | 2017 | Retrospective | 38 | Stage IV rectal cancer with synchronous distant metastases | 25 Gy/5 fx | 25 (14.75-42.25) months | 1-year OS 97%
2-year OS 86.2%
3-year OS 76%
1-year PFS 52.1%
2-year PFS 22.7%
3-year PFS 17% |
| Bisschop et al. [79] | 2017 | Prospective, multicenter phase 2 study | 50 | Stage IV rectal cancer with synchronous distant metastases | 25 Gy/5 fx | 8.1 (6-9.8) years | Median OS 3.8 ( 0.5–9.4) years for all patients
2-year OS 74%
5-year OS 38%
For 36 of 50 patients (72%) with radical (R0) primary tumor and metastatic site treatment, median OS 4.4 years, LR 5.6%, distant recurrence 80.6% |
| D'Hondt et al. [105] | 2017 | Retrospective multicenter study | 18 | Stage IV rectal cancer with synchronous liver metastases | - | 20.5 (3.6–63.1) months | 3 patients died and 10 patients had tumor progression during the follow-up period
Median time to progression after liver surgery 4.2 (2.8–9.2) months |
| Labori et al. [84] | 2017 | Retrospective | 45 | Stage IV rectal cancer with synchronous liver metastases | 50 Gy/25 fx (53%) or 25 Gy/5 fx (47%) | 48 (6-85) months | Median OS 48.4 (43.3-54.8) months for all patients
For the 40 patients completing the treatment sequence, median OS 49.7 (45.2-57.1) months and recurrence free survival 13 (16-30.3) months |
| Salvador-Rosés et al. [75] | 2018 | Prospective | 35 | Stage IV rectal cancer with synchronous liver metastases | 50.4 Gy | 38 (11-64) months | Median disease free survival 26 (23–28) months
Median OS 53 (36-69) months for patients completing treatment strategy
Median OS 25 (7-42) months for patients not completing treatment strategy |
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