ArticleThe Lancet regional health. Europe2026
Microwave ablation versus stereotactic body radiotherapy for oligometastatic colorectal liver metastases (LAVA-CRLM): a prospective, randomised, phase II trial.
Article in The Lancet regional health. Europe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03654131 (Stereotactic Body Radiation Therapy vs. Microwave Ablation for Colorectal Cancer Patients With Metastatic Disease in the Liver - a Randomized Phase II Trail), which is not on this map. Not yet cited in PubMed.
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Stereotactic Body Radiation Therapy vs. Microwave Ablation for Colorectal Cancer Patients With Metastatic Disease in the Liver - a Randomized Phase II Trail
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10 authors.
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Abstract
Background: Local therapies can achieve durable disease control in selected patients with oligometastatic colorectal liver metastases. Microwave ablation (MWA) is widely used, whereas stereotactic body radiotherapy (SBRT) is a non-invasive alternative with limited prospective comparative evidence. We aimed to compare freedom from local progression and safety of MWA versus SBRT. Methods: LAVA-CRLM was a randomised, phase II trial conducted at two centres in Copenhagen, Denmark. Adults with one to three colorectal liver metastases, each ≤4.0 cm, deemed suitable for both MWA and SBRT with curative intent by a multidisciplinary team were randomly assigned (1:1) to MWA or SBRT. The primary endpoint was freedom from local progression in the modified intention-to-treat population. Toxicity was assessed in the safety population. The trial is registered with ClinicalTrials.gov (NCT03654131). Findings: Between Jan 29, 2019, and Dec 3, 2024, 100 patients were randomly assigned; 92 were included in the modified intention-to-treat population. At a median follow-up of 34.9 months, 1-year freedom from local progression was 77.7% (95% CI 66.5-90.9) with MWA and 83.0% (72.3-95.4) with SBRT (hazard ratio 0.87, 95% CI 0.43-1.74; p = 0.70). Grade 2 or higher treatment-related toxicity occurred in 13 (25%) of 52 patients treated with MWA and one (3%) of 40 treated with SBRT. Grade 3 or higher toxicity occurred only with MWA (four [8%] patients), including one treatment-related death. Interpretation: SBRT demonstrated a more favourable treatment-related safety profile, with no difference in freedom from local progression detected between SBRT and MWA in this phase II study. These findings support consideration of SBRT as a non-invasive local treatment option for selected patients with oligometastatic colorectal liver metastases. Funding: Danish Cancer Society.
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