Oligometastatic disease and remote stereotactic body ablative radiotherapy. Part IV. Colorectal cancer

Colorectal cancer is the third most common cancer worldwide and has a high rate of metastasis, which is the leading cause of mortality from this disease. Oligometastatic disease refers to a clinical condition recently included in the European Society for Medical Oncology (ESMO) guidelines that may benefit from a more aggressive locoregional approach.Currently, treatment modalities for patients with oligometastatic colorectal carcinoma are rapidly evolving. Although surgery remains the gold standard with a favorable prognosis in operable metastatic lesions, unfortunately, the majority (70-80%) of patients are unsuitable candidates for resection due to clinical (comorbidities) and/or surgical technical factors such as metastatic tumor size, anatomic location, multifocality, and several others. In this regard, it is remote stereotactic body ablative radiotherapy, which is quite well tolerated by patients, up to the possibility of its performance in outpatient conditions, prolongs the survival of patients without tumor progression, improves their overall life expectancy and sometimes contributes to complete cure in a certain category of patients. Therefore, ESMO has announced the inclusion of both surgical resection and local ablative therapies in the treatment algorithm for oligometastatic disease. This review, which is a continuation of a series of articles on oligometastatic disease in cancer patients, attempts to familiarize the reader with the current role of remote stereotactic ablative radiotherapy in patients with colorectal cancer.