Capecitabine maintenance after radiofrequency ablation: A preventive strategy for lung oligometastases from colorectal cancer

Table 1 Summary of key international studies evaluating the integration of capecitabine or other systemic strategies with locoregional treatments (surgery, radiofrequency ablation, stereotactic ablative radiotherapy) in oligometastatic colorectal cancer

Ref.	Year	Study type	Population (n)	Locoregional treatment	Capecitabine/systemic role	Follow-up	Outcomes	Main results
Li et al[1]	2025	Retrospective multicenter	247	RFA (CRC lung oligometastases)	Capecitabine maintenance vs none	Median 53 months	OS, PFS, local progression	5-year OS 88.7% vs 69.1% (HR = 0.31, 95%CI: 0.12-0.79); 5-year LTP 22.7% vs 49%
de Baère et al[10]	2015	Multicenter retrospective	566 patients/1037 metastases	RFA (lung)	Systemic varied	Median 31 months	Local control, OS	Local efficacy rate approximately 90%; 5-year OS approximately 51%
Nordlinger et al[18]	2013	RCT phase III	364	Surgery (liver metastases)	Perioperative FOLFOX	Median 8.5 years	PFS, OS	HR PFS 0.77 (95%CI 0.62-0.96); 3-year PFS 36% vs 28%
Palma et al[11]	2020	RCT phase II	99 (various tumors)	SABR to all oligometastases	Systemic per histology	Median 51 months	OS, PFS	5-year OS 42% vs 17% (HR = 0.47, P = 0.006)
Sonbol et al[21]	2020	Systematic review and NMA	Approximately 5540 patients	Mixed locoregional	Maintenance chemo		PFS, OS	PFS consistently improved; OS effect variable
Geng et al[19]	2020	Pilot retrospective	32	XELOX induction-NED	Metronomic capecitabine	Median 14 months	PFS, tolerability	Median PFS 6.8 months; well tolerated
Kim et al[20]	2011	Phase II salvage	75	No local therapy	Capecitabine monotherapy	Median 6 months	Disease control, safety	DCR approximately 30%; manageable toxicity
Chu and Dupuy[13]	2014	Review		Ablation biology	Mechanistic rationale			Ablation induces immune modulation, antigen release
Delpla et al[22]	2021	Review		Thermal ablation (lung metastases)	Systemic combinations			Supports combined strategies; calls for prospective trials
Cervantes et al[9]	2023	Guideline		Surgery/RFA	Systemic therapy integration			ESMO guidance for mCRC; recommends multimodal management

RCT: Randomized controlled trial; NMA: Network meta-analysis; RFA: Radiofrequency ablation; CRC: Colorectal cancer; SABR: Stereotactic ablative radiotherapy; XELOX: Capecitabine and oxaliplatin; NED: No evidence of disease; FOLFOX: Fluorouracil, oxaliplatin, and leucovorin; OS: Overall survival; PFS: Progression-free survival; HR: Hazard ratio; CI: Confidence interval; LTP: Local tumor progression; DCR: Disease control rate; ESMO: European Society for Medical Oncology; mCRC: Metastatic colorectal cancer.