Differences Between Colon Cancer Primaries and Metastases Using a Molecular Assay for Tumor Radiation Sensitivity Suggest Implications for Potential Oligometastatic SBRT Patient Selection.
Differences Between Colon Cancer Primaries and Metastases Using a Molecular Assay for Tumor Radiation Sensitivity Suggest Implications for Potential Oligometastatic SBRT Patient Selection.
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结肠癌初选和使用分子测定的转移酶之间的差异对肿瘤辐射敏感性表明对潜在的寡量转移SBRT患者选择的影响。
DOI：
10.1016/j.ijrobp.2015.01.036
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发表时间：
2015-07-15
影响因子：
7
通讯作者：
Torres-Roca, Javier F.
中科院分区：
文献类型：
--
作者：
Ahmed, Kamran A.;Fulp, William J.;Berglund, Anders E.;Hoffe, Sarah E.;Dilling, Thomas J.;Eschrich, Steven A.;Shridhar, Ravi;Torres-Roca, Javier F.
我们之前已经开发了肿瘤放射敏感性（RSI）的多基因表达模型，并在多个独立队列（乳房、直肠、食管和头颈部）中进行了临床验证。本研究的目的是评估原发性结肠癌和转移性结肠癌RSI评分的差异。患者从我们机构IRB批准的前瞻性观察方案中确定。从去识别的元数据池中获得了704例转移性病变和1362例原发性病变。RSI是使用先前发表的基于排名的算法计算的。采用5段立体定向放疗（SBRT）治疗60 Gy的29例肺或肝结肠转移瘤的独立队列进行验证。最常见的转移部位包括肝脏（n=374, 53%）、肺（n=116, 17%）和淋巴结（n=40, 6%）。60%的转移性肿瘤与54%的原发肿瘤处于RSI-RR峰值，提示转移性肿瘤可能比原发肿瘤略高放射耐药（p=0.01）。相反，当我们根据解剖部位分析转移时，我们发现了RSI的巨大差异。肿瘤转移的中位RSIs依次为卵巢（0.48）、腹部（0.47）、肝脏（0.43）、脑部（0.42）、肺部（0.32）、淋巴结（0.31），p<0.0001。当分析仅限于同一患者（n=139）的病变时，这些发现得到了证实。在我们治疗的肺和肝转移患者的独立队列中，肺转移患者的局部控制率（LC）高于肝转移患者（2年LC 100% vs. 73.0%, p=0.026）。评估结肠癌原发组织和转移组织的组织学放射敏感性，发现基于转移的解剖位置有显著差异。这些初步结果值得在更大的临床队列中验证。
We have previously developed a multigene expression model of tumor radiosensitivity (RSI) with clinical validation in multiple independent cohorts (breast, rectal, esophageal, and head and neck). The purpose of this study was to assess differences in RSI scores between primary colon cancer and metastases. Patients were identified from our institutional IRB approved prospective observational protocol. A total of 704 metastatic and 1,362 primary lesions were obtained from a de-identified meta-data pool. RSI was calculated using the previously published ranked based algorithm. An independent cohort of 29 lung or liver colon metastases treated with 60 Gy in 5 fractions stereotactic body radiotherapy (SBRT) was used for validation. The most common sites of metastases included liver (n=374; 53%), lung (n=116; 17%), and lymph nodes (n=40; 6%). Sixty percent of metastatic tumors compared with 54% of primaries were in the RSI-radioresistant (RSI-RR) peak, suggesting that, metastatic tumors may be slightly more radioresistant than primaries (p=0.01). In contrast, when we analyzed metastases based on anatomical site, we uncovered large differences in RSI. The median RSIs for metastases in descending order of radioresistance were ovary (0.48), abdomen (0.47), liver (0.43), brain (0.42), lung (0.32), and lymph nodes (0.31), p<0.0001. These findings were confirmed when the analysis was restricted to lesions from the same patient (n=139). In our independent cohort of treated lung and liver metastases, lung metastases had an improved local control (LC) rate over patients with liver metastases (2 yr LC 100% vs. 73.0%, p=0.026). Assessment of radiosensitivity between primary and metastatic tissues of colon cancer histology, reveals significant differences based on anatomical location of metastases. These initial results warrant validation in a larger clinical cohort.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
11.2
作者：
Smid, Marcel;Wang, Yixin;Martens, John W. M.
通讯作者：
Martens, John W. M.
DOI：
10.1016/j.ijrobp.2004.02.060
发表时间：
2004-09-01
影响因子：
7
作者：
Wulf, J;Haedinger, U;Flentje, M
通讯作者：
Flentje, M
影响因子：
11.5
作者：
Eschrich, Steven A.;Fulp, William J.;Torres-Roca, Javier F.
通讯作者：
Torres-Roca, Javier F.
影响因子：
3.7
作者：
Rule, William;Timmerman, Robert;Cho, L. Chinsoo
通讯作者：
Cho, L. Chinsoo