Increased efficacy of stereotactic ablative radiation therapy after bevacizumab in lung oligometastases from colon cancer



Metastases from colorectal cancer are poorly responsive to stereotactic ablative radiation therapy (SABR) due to intratumoral hypoxia. Intratumoral oxygenation is improved by administration of angiogenesis inhibitors. Thus, there could be a clinical synergistic effect of SABR with bevacizumab on metastases from colorectal cancer. The aim of this study was to evaluate the feasibility and efficacy of SABR after bevacizumab in lung oligometastases from colon cancer.


The data of patients with lung metastases from colon cancer who underwent SABR were retrospectively evaluated according to the following inclusion criteria: number of metastases ≤3; lung oligometastases from colon cancer in patients who underwent SABR; patients receiving previous chemotherapy alone or in combination with bevacizumab; Karnofsky performance status >80; life expectancy >6 months; at least 6 months’ follow-up after SABR; presence of KRAS mutation. The results were compared with those of a similar cohort of patients with irradiated lung lesions from colorectal cancer in whom bevacizumab was not previously administered.


A total of 40 lung metastases were analyzed. The complete response rate after SABR was higher in patients who had received bevacizumab than in those who had not (p = 0.04). Additionally, in the bevacizumab group, a higher rate of post-SABR complete response was observed in case of oligopersistent versus oligorecurrent metastases (p = 0.001).


In the setting of lung oligometastases from colon cancer the present study attested the higher efficacy of SABR after bevacizumab administration. Further studies in this field of research are strongly advocated.

Post author correction


Article Subject: Radiotherapy



Rosario Mazzola, Umberto Tebano, Dario Aiello, Gioacchino Di Paola, Niccolò Giaj-Levra, Francesco Ricchetti, Sergio Fersino, Alba Fiorentino, Ruggero Ruggieri, Filippo Alongi

Article History


Financial support: None.
Conflict of interest: The authors have no conflicts of interest to disclose.

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  • Radiation Oncology, Sacro Cuore Don Calabria Hospital, Negrar (Verona) - Italy
  • Radiation Oncology School, University of Padua, Padua - Italy
  • Radiation Oncology School, University of Palermo, Palermo - Italy
  • University of Brescia, Brescia - Italy

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