PURPOSE/OBJECTIVE(S) To report tumor genomic factors associated with overall survival (OS) and local failure (LF) for patients with colorectal cancer (CRC) who received metastasis-directed stereotactic body radiation therapy (SBRT). MATERIALS/METHODS This was a retrospective review of patients with CRC who received metastasis-directed SBRT. Tumor genomic alterations were identified through KRAS, BRAF, or a 50-gene next generation sequencing panel. OS and LF were estimated using Kaplan-Meier and competing-risk methods. RESULTS Eighty-five patients and 109 lesions were treated between 2008 and 2018. The median patient follow-up was 50 months (IQR: 28-107). The median and 5-year OS was 34 months and 26% (95% CI: 16-41%), respectively. The 2-year cumulative incidence of LF was 30% (95% CI: 23-41%). Univariate associates with OS included patient age ≥60 years, bone metastasis, increasing tumor size, KRAS mutation, and combined KRAS and TP53 mutation, while increasing tumor size, bone metastasis, biologically effective dose <100 Gy, and combined KRAS and TP53 mutation were associated with LF. Multivariate associates with OS included patient age ≥60 years (HR: 2.4, 95% CI: 1.2-4.8, p = 0.01), lesion size per 1 cm (HR: 1.3, 95% CI: 1.1-1.5, p < 0.01), and KRAS mutation (HR: 2.2, 95% CI: 1.2-4.3, p < 0.01), while no multivariable model for LF retained more than a single variable. CONCLUSION Genomic factors, in particular KRAS and TP53 mutation, may assist in patient selection and radiotherapeutic decision-making for patients with oligometastatic CRC. Prospective validation, ideally with genomic correlation of all irradiated metastases, is warranted.

中文翻译：

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肿瘤基因组因素与转移定向立体定向放疗治疗寡转移性结直肠癌疗效的相关性

目的/目的(S) 报告与接受转移定向立体定向放射治疗 (SBRT) 的结直肠癌 (CRC) 患者的总生存 (OS) 和局部失败 (LF) 相关的肿瘤基因组因素。材料/方法 这是对接受转移定向 SBRT 的 CRC 患者的回顾性研究。肿瘤基因组改变是通过 KRAS、BRAF 或 50 基因的下一代测序面板确定的。使用 Kaplan-Meier 和竞争风险方法估计 OS 和 LF。结果 2008 年至 2018 年间共治疗了 85 名患者和 109 个病灶。患者的中位随访时间为 50 个月（IQR：28-107）。中位 OS 和 5 年 OS 分别为 34 个月和 26%（95% CI：16-41%）。LF 的 2 年累积发生率为 30%（95% CI：23-41%）。与 OS 相关的单变量包括患者年龄 ≥60 岁、骨转移、肿瘤大小增加、KRAS 突变以及 KRAS 和 TP53 突变联合，而肿瘤大小增加、骨转移、生物学有效剂量 <100 Gy 以及 KRAS 和 TP53 突变联合是与 LF 相关。与 OS 相关的多变量因素包括患者年龄 ≥ 60 岁（HR：2.4，95% CI：1.2-4.8，p = 0.01），每 1 cm 病灶大小（HR：1.3，95% CI：1.1-1.5，p < 0.01）和 KRAS 突变（HR：2.2，95% CI：1.2-4.3，p < 0.01），而 LF 的多变量模型没有保留一个以上的变量。结论 基因组因素，特别是 KRAS 和 TP53 突变，可能有助于寡转移性 CRC 患者的患者选择和放射治疗决策。前瞻性验证，理想情况下与所有辐射转移的基因组相关性，