In pulmonary oligometastases from colorectal cancer (POM-CRC), metastasectomy is the primarily recommended treatment. Stereotactic body radiotherapy (SBRT) has been suggested as a viable alternative therapy. SBRT efficacy for POM-CRC is poorly delineated compared to selected non-CRC primaries. This perspective article aims to critically summarize the existing evidence regarding efficacy of SBRT in terms of overall survival (OS) and local control (LC), and factors modulating this, in the treatment of POM-CRC. Overall, reasonable LC and OS rates were observed. The wide range of expansions in planning target volume margins introduced variation in pretreatment protocols. Dose-fractionation schedules varied according to patient and tumor characteristics, though leverage of BED₁₀ in select studies enabled standardization. An association between SBRT dose and improved OS and LC was observed across multiple studies. Prognostic factors that were associated with improved LC included: fewer oligometastases, absence of extra-pulmonary metastases, primary tumor histology, and smaller gross tumor volume. Differences in SBRT modality and techniques over time further confounded results. Many studies included patients receiving additional systemic therapies; preprotocol and adjuvant chemotherapies were identified as prognostic factors for LC. SBRT compared with metastasectomy showed no differences in short-term OS and LC outcomes. In conclusion, SBRT is an efficacious treatment for POM-CRC, in terms of OS and LC. Heterogeneity in study design, particularly pertaining to dose protocols, patient selection, and additional therapies should be controlled for future randomized studies to further validate SBRT efficacy.

对于结直肠癌肺部寡转移（POM-CRC），转移瘤切除术是主要推荐的治疗方法。立体定向全身放射治疗（SBRT）已被建议作为一种可行的替代疗法。与选定的非 CRC 初选相比，SBRT 对 POM-CRC 的疗效描述很差。这篇前瞻性文章旨在批判性地总结关于 SBRT 在 POM-CRC 治疗中在总生存 (OS) 和局部控制 (LC) 方面的疗效以及调节这一效果的因素的现有证据。总体而言，观察到合理的 LC 和 OS 率。计划目标体积裕度的广泛扩展引入了预处理方案的变化。_{尽管在选定的研究中利用 BED 10}实现了标准化，但剂量分割方案根据患者和肿瘤特征而有所不同。多项研究均观察到 SBRT 剂量与改善 OS 和 LC 之间存在关联。与 LC 改善相关的预后因素包括：较少的寡转移、不存在肺外转移、原发肿瘤组织学和较小的肿瘤总体积。随着时间的推移，SBRT 模式和技术的差异进一步混淆了结果。许多研究纳入了接受额外全身治疗的患者；方案前和辅助化疗被确定为 LC 的预后因素。SBRT 与转移瘤切除术相比，短期 OS 和 LC 结果没有差异。总之，就 OS 和 LC 而言，SBRT 是 POM-CRC 的有效治疗方法。研究设计中的异质性，特别是与剂量方案、患者选择和其他疗法有关的异质性，应在未来的随机研究中得到控制，以进一步验证 SBRT 的疗效。