A propensity score matched retrospective analysis of 251 patients receiving definitive surgery (n=173) or ablative radiation (n=78) for lung mets from colorectal cancer reports similar overall survival at 5 years with either approach (69% versus 73%, respectively). Of note, local recurrence was more likely after radiation (33%) than surgery (17%) and distant lung failure more likely after surgery (72%) than after radiation (43%). An increased local recurrence rate with radiation perhaps is unsurprising considering (1) radiation at this center was reserved for tumors requiring “extensive lung resection” or when surgeons and/or patients felt surgery wasn’t ideal and (2) the vast majority of radiation prescriptions were only 50 Gy in 5 fractions for a notoriously radioresistant histology. Interestingly, nearly two-thirds of each group went on to receive further definitive local therapies, which may have contributed to the impressive long-term survival cited above. | Wang, Int J Radiat oncol Biol Phys 2024
