open access

Vol 25, No 6 (2020)
Original research articles
Published online: 2020-11-01
Submitted: 2020-05-12
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A single-institutional experience with low dose stereotactic body radiation therapy for liver metastases

Roman O. Kowalchuk, Michael R. Waters, K. Martin Richardson, Kelly M. Spencer, James M. Larner, C.R. Kersh
DOI: 10.1016/j.rpor.2020.09.010
·
Rep Pract Oncol Radiother 2020;25(6):987-993.

open access

Vol 25, No 6 (2020)
Original research articles
Published online: 2020-11-01
Submitted: 2020-05-12

Abstract

Aim

This study reports a single-institutional experience treating liver metastases with stereotactic body radiation therapy (SBRT).

Materials and methods

107 patients with 169 lesions were assessed to determine factors predictive for local control, radiographic response, and overall survival (OS). Machine learning techniques, univariate analysis, and the Kaplan-Meier method were utilized.

Results

Patients were treated with a relatively low median dose of 30 Gy in 3 fractions. Fractions were generally delivered once weekly. Median biologically effective dose (BED) was 60 Gy, and the median gross tumor volume (GTV) was 12.16 cc. Median follow-up was 7.36 months. 1-year local control was 75% via the Kaplan-Meier method. On follow-up imaging, 43%, 40%, and 17% of lesions were decreased, stable, and increased in size, respectively. 1-year OS was 46% and varied by primary tumor, with median OS of 34.3, 25.1, 12.5, and 4.6 months for ovarian, breast, colorectal, and lung primary tumors, respectively. Breast and ovarian primary patients had better OS (p < 0.0001), and lung primary patients had worse OS (p = 0.032). Higher BED values, the number of hepatic lesions, and larger GTV were not predictive of local control, radiographic response, or OS. 21% of patients suffered from treatment toxicity, but no grade ≥3 toxicity was reported.

Conclusion

Relatively low-dose SBRT for liver metastases demonstrated efficacy and minimal toxicity, even for patients with large tumors or multiple lesions. This approach may be useful for patients in whom higher-dose therapy is contraindicated or associated with high risk for toxicity. OS depends largely on the primary tumor.

Abstract

Aim

This study reports a single-institutional experience treating liver metastases with stereotactic body radiation therapy (SBRT).

Materials and methods

107 patients with 169 lesions were assessed to determine factors predictive for local control, radiographic response, and overall survival (OS). Machine learning techniques, univariate analysis, and the Kaplan-Meier method were utilized.

Results

Patients were treated with a relatively low median dose of 30 Gy in 3 fractions. Fractions were generally delivered once weekly. Median biologically effective dose (BED) was 60 Gy, and the median gross tumor volume (GTV) was 12.16 cc. Median follow-up was 7.36 months. 1-year local control was 75% via the Kaplan-Meier method. On follow-up imaging, 43%, 40%, and 17% of lesions were decreased, stable, and increased in size, respectively. 1-year OS was 46% and varied by primary tumor, with median OS of 34.3, 25.1, 12.5, and 4.6 months for ovarian, breast, colorectal, and lung primary tumors, respectively. Breast and ovarian primary patients had better OS (p < 0.0001), and lung primary patients had worse OS (p = 0.032). Higher BED values, the number of hepatic lesions, and larger GTV were not predictive of local control, radiographic response, or OS. 21% of patients suffered from treatment toxicity, but no grade ≥3 toxicity was reported.

Conclusion

Relatively low-dose SBRT for liver metastases demonstrated efficacy and minimal toxicity, even for patients with large tumors or multiple lesions. This approach may be useful for patients in whom higher-dose therapy is contraindicated or associated with high risk for toxicity. OS depends largely on the primary tumor.

Get Citation

Keywords

Metastasis; SBRT; SABR; Liver; Dose-fractionation

About this article
Title

A single-institutional experience with low dose stereotactic body radiation therapy for liver metastases

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 6 (2020)

Pages

987-993

Published online

2020-11-01

DOI

10.1016/j.rpor.2020.09.010

Bibliographic record

Rep Pract Oncol Radiother 2020;25(6):987-993.

Keywords

Metastasis
SBRT
SABR
Liver
Dose-fractionation

Authors

Roman O. Kowalchuk
Michael R. Waters
K. Martin Richardson
Kelly M. Spencer
James M. Larner
C.R. Kersh

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