Radiosurgery for liver metastases. A single institution experience

Abstract

Aim

To report our initial results on the use of radiosurgery for treatment of liver metastases.

Background

In recent years there has been increasing interest in the use of stereotactic body radiation therapy to treat metastatic disease to the liver as an alternative to interventional procedures.

Materials and methods

Between November 2008 and June 2015 a total of 36 LINAC-based radiosurgeries using VMAT were performed in 27 patients with liver metastases from 10 different primary sites. Doses ranged from 21[[ce:hsp sp="0.25"/]]Gy to 60[[ce:hsp sp="0.25"/]]Gy in 1 to 5 fractions. In all patients the volume of liver receiving less than 15[[ce:hsp sp="0.25"/]]Gy was more than 700[[ce:hsp sp="0.25"/]]cc. The volume treated with the prescription dose ranged from 1[[ce:hsp sp="0.25"/]]cc to 407[[ce:hsp sp="0.25"/]]cc with a median of 58[[ce:hsp sp="0.25"/]]cc. All patients but one received systemic treatment.

Results

Overall median survival for the entire group is 9 months (ranging from 1 to 67 months). Local recurrence free survival ranged from 4 to 67 months with a median of 14 months.

Twenty patients (80%) survived more than six months. Three patients treated for oligometastases were alive after 3 years. Grade 0 toxicity was encountered in 22/27 patients, Grade 1 toxicity in 5/27 and only 1/27 patient experienced Grade 2 toxicity. No patient experienced grade 3–4 toxicity.

Conclusion

Based on these initial results we conclude that SBRT for treating liver metastases with radiosurgery is safe and effective for treating one or multiple lesions as long as normal tissue constraints for liver are respected.