{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:08:57Z","timestamp":1776337737436,"version":"3.51.2"},"reference-count":41,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Varian research grant"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: Surgical resection of liver or pulmonary oligometastases (LP-OMD) in colorectal cancer (CRC) has been shown to improve survival. Stereotactic body radiotherapy (SBRT) is a promising alternative for patients with primary lung cancer. However, the efficacy of SBRT for LP-OMD in CRC remains inconclusive, and local control (LC) rates are often unsatisfactory. This prospective study aimed to evaluate the treatment outcomes of dose-escalated and convergent SBRT for patients with LP-OMD from CRC, with the goal of demonstrating its effectiveness as a treatment option for these patients. Methods and materials: This study included 23 CRC patients with LP-OMD who received SBRT between 2017 and 2022. The inclusion criteria were histologically confirmed colorectal adenocarcinoma, one to three oligometastases, and a tumor diameter of 5 cm or less. Patients who were inoperable or declined surgery were included. SBRT was delivered with total doses of 50\u201360 Gy administered over five fractions, covering the planning target volume surface within the 60% isodose line of the maximum dose. The primary endpoint was the 2-year LC rate, while secondary endpoints included overall survival (OS), progression-free survival (PFS), and toxicity. Results: The median follow-up duration was 41.0 months (range: 11.5\u201377.2). At the time of analysis, five patients had died from CRC, six were alive with disease, and twelve were alive without disease. Only one patient experienced local recurrence of a pulmonary oligometastasis. The 2-year LC, PFS, and OS rates were 95.0% (95% CI: 69.5\u201399.3), 61.3% (95% CI: 40.0\u201377.0), and 88.1% (95% CI: 67.6\u201396.0), respectively. Toxicity was acceptable, with no grade \u2265 3 adverse events. Conclusions: High-central-dose SBRT for LP-OMD from CRC achieved favorable local control with minimal toxicity. These findings should be interpreted cautiously and require validation in larger, multi-institutional studies.<\/jats:p>","DOI":"10.3390\/cancers18081263","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T10:14:46Z","timestamp":1776334486000},"page":"1263","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Phase II Study of Dose-Escalated and Convergent Stereotactic Body Radiotherapy for Liver and Pulmonary Oligometastases from Colorectal Cancer"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5902-7860","authenticated-orcid":false,"given":"Shuichi","family":"Nishimura","sequence":"first","affiliation":[{"name":"Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura-shi 247-0056, Kanagawa, Japan"},{"name":"Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2820-0760","authenticated-orcid":false,"given":"Atsuya","family":"Takeda","sequence":"additional","affiliation":[{"name":"Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura-shi 247-0056, Kanagawa, Japan"},{"name":"Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0872-2000","authenticated-orcid":false,"given":"Yuichiro","family":"Tsurugai","sequence":"additional","affiliation":[{"name":"Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura-shi 247-0056, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0274-9771","authenticated-orcid":false,"given":"Naoko","family":"Sanuki","sequence":"additional","affiliation":[{"name":"Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahisa","family":"Eriguchi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Saitama Red Cross Hospital, Saitama-shi 330-0081, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5370-0970","authenticated-orcid":false,"given":"Takafumi","family":"Nemoto","sequence":"additional","affiliation":[{"name":"Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura-shi 247-0056, Kanagawa, Japan"},{"name":"Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.annonc.2022.10.003","article-title":"Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"34","author":"Cervantes","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"29765","DOI":"10.1038\/srep29765","article-title":"Patterns of metastasis in colon and rectal cancer","volume":"6","author":"Hemminki","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1097\/COC.0b013e3181fe4444","article-title":"Viewing metastatic colorectal cancer as a curable chronic disease","volume":"35","author":"Chua","year":"2012","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_4","unstructured":"National Comprehensive Cancer Network (NCCN) (2023). Clinical Practice Guidelines in Oncology (NCCN Guidelines\u00ae), National Comprehensive Cancer Network. Colon Cancer. Version 4.2023."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1097\/00000658-200012000-00006","article-title":"Two-stage hepatectomy: A planned strategy to treat irresectable liver tumors","volume":"232","author":"Adam","year":"2000","journal-title":"Ann. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1002\/bjs.9492","article-title":"Failure to rescue as a source of variation in hospital mortality after hepatic surgery","volume":"101","author":"Spolverato","year":"2014","journal-title":"Br. J. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1007\/s00268-015-3019-3","article-title":"Postoperative complications affect long-term survival outcomes following hepatic resection for colorectal liver metastasis","volume":"39","author":"Yin","year":"2015","journal-title":"World J. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1002\/bjs.9060","article-title":"Impact of complications on long-term survival after resection of colorectal liver metastases","volume":"100","author":"Mavros","year":"2013","journal-title":"Br. J. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1016\/S1470-2045(21)00401-0","article-title":"Stereotactic ablative radiotherapy for operable stage I non-small-cell lung cancer (revised STARS): Long-term results of a single-arm, prospective trial with prespecified comparison to surgery","volume":"22","author":"Chang","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1016\/S0140-6736(18)32487-5","article-title":"Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): A randomised, phase 2, open-label trial","volume":"393","author":"Palma","year":"2019","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.radonc.2011.05.033","article-title":"Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer","volume":"101","author":"Takeda","year":"2011","journal-title":"Radiother. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"5187","DOI":"10.21037\/jtd.2019.12.12","article-title":"A systematic review and meta-analysis of stereotactic body radiation therapy for colorectal pulmonary metastases","volume":"11","author":"Cao","year":"2019","journal-title":"J. Thorac. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1093\/jrr\/rrw029","article-title":"Stereotactic body radiotherapy for patients with oligometastases from colorectal cancer: Risk-adapted dose prescription with a maximum dose of 83-100 Gy in five fractions","volume":"57","author":"Takeda","year":"2016","journal-title":"J. Radiat. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1016\/S1470-2045(19)30718-1","article-title":"Characterisation and classification of oligometastatic disease: A European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus recommendation","volume":"21","author":"Guckenberger","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1093\/jrr\/rry112","article-title":"Stereotactic body radiotherapy for patients with non-small-cell lung cancer using RapidArc delivery and a steep dose gradient: Prescription of 60% isodose line of maximum dose fitting to the planning target volume","volume":"60","author":"Tsurugai","year":"2019","journal-title":"J. Radiat. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1080\/0284186X.2021.2001566","article-title":"Feasibility of marker-less stereotactic body radiotherapy for hepatocellular carcinoma","volume":"61","author":"Kibe","year":"2022","journal-title":"Acta Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur. J. Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/bmt.2012.244","article-title":"Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics","volume":"48","author":"Kanda","year":"2013","journal-title":"Bone Marrow Transplant."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00432-014-1833-x","article-title":"Final results of a phase II trial for stereotactic body radiation therapy for patients with inoperable liver metastases from colorectal cancer","volume":"141","author":"Scorsetti","year":"2015","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.ijrobp.2017.04.010","article-title":"Long-Term Outcomes of Phase 1 and 2 Studies of SBRT for Hepatic Colorectal Metastases","volume":"99","author":"McPartlin","year":"2017","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_21","first-page":"374","article-title":"Liver-directed therapies in metastatic colorectal cancer","volume":"5","author":"Clark","year":"2014","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.athoracsur.2007.02.093","article-title":"Surgical resection of pulmonary metastases from colorectal cancer: A systematic review of published series","volume":"84","author":"Pfannschmidt","year":"2007","journal-title":"Ann. Thorac. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"djx015","DOI":"10.1093\/jnci\/djx015","article-title":"Local Treatment of Unresectable Colorectal Liver Metastases: Results of a Randomized Phase II Trial","volume":"109","author":"Ruers","year":"2017","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/S1470-2045(24)00660-0","article-title":"Thermal ablation versus surgical resection of small-size colorectal liver metastases (COLLISION): An international, randomised, controlled, phase 3 non-inferiority trial","volume":"26","author":"Puijk","year":"2025","journal-title":"Lancet Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.radonc.2013.05.024","article-title":"Pulmonary oligometastases: Metastasectomy or stereotactic ablative radiotherapy?","volume":"107","author":"Widder","year":"2013","journal-title":"Radiother. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2830","DOI":"10.1200\/JCO.20.00818","article-title":"Stereotactic Ablative Radiotherapy for the Comprehensive Treatment of Oligometastatic Cancers: Long-Term Results of the SABR-COMET Phase II Randomized Trial","volume":"38","author":"Palma","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1533033818794936","DOI":"10.1177\/1533033818794936","article-title":"Stereotactic Radiotherapy for Pulmonary Oligometastases From Colorectal Cancer: A Systematic Review and Meta-Analysis","volume":"17","author":"Jingu","year":"2018","journal-title":"Technol. Cancer Res. Treat."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.radonc.2021.12.018","article-title":"An analysis of a large multi-institutional database reveals important associations between treatment parameters and clinical outcomes for stereotactic body radiotherapy (SBRT) of oligometastatic colorectal cancer","volume":"167","author":"Sheikh","year":"2022","journal-title":"Radiother. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1093\/jrr\/rraa071","article-title":"Analyses of local control and survival after stereotactic body radiotherapy for pulmonary oligometastases from colorectal adenocarcinoma","volume":"61","author":"Yamamoto","year":"2020","journal-title":"J. Radiat. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1097\/COC.0000000000000864","article-title":"Local Recurrence Outcomes of Colorectal Cancer Oligometastases Treated With Stereotactic Ablative Radiotherapy","volume":"44","author":"Benson","year":"2021","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.ijrobp.2015.01.036","article-title":"Differences Between Colon Cancer Primaries and Metastases Using a Molecular Assay for Tumor Radiation Sensitivity Suggest Implications for Potential Oligometastatic SBRT Patient Selection","volume":"92","author":"Ahmed","year":"2015","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Klement, R.J., Abbasi-Senger, N., Adebahr, S., Alheid, H., Allgaeuer, M., Becker, G., Blanck, O., Boda-Heggemann, J., Brunner, T., and Duma, M. (2019). The impact of local control on overall survival after stereotactic body radiotherapy for liver and lung metastases from colorectal cancer: A combined analysis of 388 patients with 500 metastases. BMC Cancer, 19.","DOI":"10.1186\/s12885-019-5362-5"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.ijrobp.2021.04.014","article-title":"Stereotactic Body Radiation Therapy With a High Maximum Dose Improves Local Control, Cancer-Specific Death, and Overall Survival in Peripheral Early-Stage Non-Small Cell Lung Cancer","volume":"111","author":"Tateishi","year":"2021","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Andratschke, N., Alheid, H., Allg\u00e4uer, M., Becker, G., Blanck, O., Boda-Heggemann, J., Brunner, T., Duma, M., Gerum, S., and Guckenberger, M. (2018). The SBRT database initiative of the German Society for Radiation Oncology (DEGRO): Patterns of care and outcome analysis of stereotactic body radiotherapy (SBRT) for liver oligometastases in 474 patients with 623 metastases. BMC Cancer, 18.","DOI":"10.1186\/s12885-018-4191-2"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ijrobp.2015.04.016","article-title":"Prospective Longitudinal Assessment of Quality of Life for Liver Cancer Patients Treated with Stereotactic Body Radiation Therapy","volume":"93","author":"Klein","year":"2015","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2341","DOI":"10.1002\/cncr.29359","article-title":"Comparative effectiveness of surgery and radiosurgery for stage I non-small cell lung cancer","volume":"121","author":"Yu","year":"2015","journal-title":"Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.lungcan.2021.07.007","article-title":"Stereotactic ablative radiotherapy in T1-2N0M0 small cell lung cancer: A systematic review and meta-analysis","volume":"160","author":"Safavi","year":"2021","journal-title":"Lung Cancer"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1245\/s10434-010-1405-5","article-title":"Phase I dose-escalation study of stereotactic body radiotherapy in patients with hepatic metastases","volume":"18","author":"Rule","year":"2011","journal-title":"Ann. Surg. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.radonc.2019.10.004","article-title":"Prognostic factors for local control and survival for inoperable pulmonary colorectal oligometastases treated with stereotactic body radiotherapy","volume":"144","author":"Sharma","year":"2020","journal-title":"Radiother. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3789","DOI":"10.1200\/JCO.21.01032","article-title":"Hepatectomy Followed by mFOLFOX6 Versus Hepatectomy Alone for Liver-Only Metastatic Colorectal Cancer (JCOG0603): A Phase II or III Randomized Controlled Trial","volume":"39","author":"Kanemitsu","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"15353508241261473","DOI":"10.1177\/15353508241261473","article-title":"Comparison of tumor non-specific and PD-L1-specific imaging by near-infrared fluorescence\/Cerenkov luminescence dual-modality in situ imaging","volume":"23","author":"Zhang","year":"2024","journal-title":"Mol. Imaging"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/8\/1263\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T10:23:27Z","timestamp":1776335007000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/8\/1263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":41,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["cancers18081263"],"URL":"https:\/\/doi.org\/10.3390\/cancers18081263","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]}}}