HPB P43 Stereotactic ablative radiotherapy is a safe and feasible option for non-surgical candidates with colorectal liver metastases


 
 
 Stereotactic ablative radiotherapy (SABR) has been associated with an improvement in over-all survival in patients with oligometastatic colorectal cancer with a controlled primary tumour and one to five oligometastatic lesions. We report our centre's experience of SABR as an alternative local therapy for non-surgical candidates with colorectal liver metastases.
 
 
 
 All patients were identified who received SABR irradiation for colorectal liver metastases in a tertiary HPB centre between June 2016 and February 2022. SABR criteria included patients with 1–3 liver metastasis with maximum tumour diameter < 6 cm, liver confined disease and a suitable performance status with pre-treatment Child-Pugh status A. A retrospective review of the patient's scans, letters and MDT outcomes was performed to analyse the pathology, indications and outcomes.
 
 
 
 18 patients with oligometastatic colorectal cancer received SABR to metastases in the liver over the study period. Five were female and 13 were male. Median age was 71. Performance status was 1 in the majority of cases (10/18). Only 2 patients had synchronous disease. 4 patients had concomitant metastatic disease to the lung and all 4 had had a lung resection. Half of the patients had a previous liver resection with 2 of these having two previous liver resections and 1 having 3 liver resections. 4/18 patients underwent SABR because they were deemed unfit for surgery, 6/18 were for anatomical indications with risk of an R1 resection and one was down to patient choice. Metastases were of median size 30 mm (9–87 mm). 89% (16/18) patients had a single metastasis, 1 patient had 2 metastases and 1 patient had 3 metastases.
 Overall survival was 19 months (4–60 months). 3 patients achieved complete resolution of disease and 4 patients had partial resolution. 6 patients were deemed to have stable disease and 4 patients had disease progression. Outcome data was not available in 1 patient. Only 2/18 pa
 
 
 
 We observed that SABR is feasible, well tolerated and effective in this cohort of patients. Longer-term follow up data is required to assess a survival benefit.
