结直肠癌（CRC）肺部寡转移的最佳局部治疗仍不清楚。我们的目的是比较手术和立体定向全身放射治疗 (SBRT) 作为 CRC 肺寡转移的初始局部治疗的长期生存结果。我们回顾性回顾了 2011 年至 2022 年期间最初接受手术或 SBRT 治疗 CRC 肺转移的 335 名连续患者，最终纳入 251 名患者（173 名接受手术和 78 名接受 SBRT）。使用稳定的治疗权重逆概率 (sIPTW) 分析比较无胸腔内进展 (FFIP)、无进展生存 (PFS) 和总生存 (OS)。此外，还分析了胸腔内进展模式和后续治疗。手术的中位随访时间为 61.6 个月，SBRT 的中位随访时间为 54.4 个月。 sIPTW 调整后，手术和 SBRT 之间的 FFIP 和 PFS 均出现显着差异（FFIP：风险比 [HR]=0.50，95% 置信区间 [CI]，0.31-0.79；PFS：HR=0.56，95% CI，0.36 -0.87）。术后3年和5年FFIP率分别为58.6%和54.8%，SBRT后分别为34.6%和31.3%（P=0.006）。术后3年和5年PFS率分别为49.4%和45.2%，SBRT后分别为28.8%和26.1%（P=0.010）。然而，治疗方法对 OS 没有显着影响（HR=0.93，95% CI，0.49-1.76）。术后3年和5年OS率分别为85.9%和73.1%，SBRT后分别为78.9%和68.7%（P=0.849）。 SBRT 后治疗部位的复发率比手术后更常见（33.3% 比 16.9%），而手术后新发胸腔肿瘤比 SBRT 后更常见（71.8% 比 43.1%）。两组均选择放疗作为主要的局部挽救治疗。尽管手术和立体定向放疗之间的 FFIP 和 PFS 存在显着差异，但 CRC 肺寡转移患者的长期生存并不取决于局部治疗方法的初始选择。版权所有 © 2024 年。由爱思唯尔公司出版。

Optimal local treatment for pulmonary oligometastases from colorectal cancer (CRC) remains unclear. We aimed to compare the long-term survival outcomes between surgery and stereotactic body radiotherapy (SBRT) as the initial local treatment for CRC pulmonary oligometastases.We retrospectively reviewed 335 consecutive patients who initially underwent surgery or SBRT for CRC pulmonary metastases from 2011 to 2022, and 251 patients (173 surgery and 78 SBRT) were ultimately included. Freedom from intrathoracic progression (FFIP), progression-free survival (PFS), and overall survival (OS) were compared using stabilized inverse probability of treatment weighting (sIPTW) analysis. In addition, patterns of intrathoracic progression and subsequent treatment were analyzed.Median follow-up was 61.6 months for surgery and 54.4 months for SBRT. After sIPTW adjustment, significant differences emerged in both FFIP and PFS between surgery and SBRT (FFIP: hazard ratio [HR] = 0.50, 95% confidence interval [CI], 0.31-0.79; PFS: HR = 0.56, 95% CI, 0.36-0.87). The 3- and 5-year FFIP rates were 58.6% and 54.8%, respectively, after surgery, and 34.6% and 31.3%, respectively, after SBRT (P = 0.006). The 3- and 5-year PFS rates were 49.4% and 45.2%, respectively, after surgery, and 28.8% and 26.1%, respectively, after SBRT (P = 0.010). However, OS was not significantly affected by treatment approach (HR = 0.93, 95% CI, 0.49-1.76). The 3- and 5-year OS rates were 85.9% and 73.1%, respectively, after surgery, and 78.9% and 68.7%, respectively, after SBRT (P = 0.849). Recurrence at the treated site was more prevalent after SBRT than after surgery (33.3% vs. 16.9%), whereas new intrathoracic tumors occurred more frequently after surgery than after SBRT (71.8% vs. 43.1%). Both groups chose radiotherapy as the primary local salvage treatment.Notwithstanding the significant differences in FFIP and PFS between surgery and SBRT, the long-term survival of patients with CRC pulmonary oligometastases did not depend on the initial choice of the local treatment approach.Copyright © 2024. Published by Elsevier Inc.