Is stereotactic body radiation therapy an attractive option for unresectable liver metastases? A preliminary report from a phase 2 trial.

Abstract

PURPOSE:

To evaluate the feasibility of high-dose stereotactic body radiation therapy (SBRT) in the treatment of unresectable liver metastases.

METHODS AND MATERIALS:

Patients with 1 to 3 liver metastases, with maximum individual tumor diameters less than 6 cm and a Karnofsky Performance Status of at least 70, were enrolled and treated by SBRT on a phase 2 clinical trial. Dose prescription was 75 Gy on 3 consecutive days. SBRT was delivered using the volumetric modulated arc therapy by RapidArc (Varian, Palo Alto, CA) technique. The primary end-point was in-field local control. Secondary end-points were toxicity and survival.

RESULTS:

Between February 2010 and September 2011, a total of 61 patients with 76 lesions were treated. Among the patients, 21 (34.3%) had stable extrahepatic disease at study entry. The most frequent primary sites were colorectal (45.9%) and breast (18%). Of the patients, 78.7% had 1 lesion, 18.0% had 2 lesions, and 3.3% had 3 lesions. After a median of 12 months (range, 2-26 months), the in-field local response rate was 94%. The median overall survival rate was 19 months, and actuarial survival at 12 months was 83.5%. None of the patients experienced grade 3 or higher acute toxicity. No radiation-induced liver disease was detected. One patient experienced G3 late toxicity at 6 months, resulting from chest wall pain.

CONCLUSIONS:

SBRT for unresectable liver metastases can be considered an effective, safe, and noninvasive therapeutic option, with excellent rates of local control and a low treatment-related toxicity.

• Authors: Marta Scorsetti, Stefano Arcangeli, Angelo Tozzi, Tiziana Comito, Filippo Alongi, Pierina Navarria, Pietro Mancosu, Giacomo Reggiori, Antonella Fogliata, Guido Torzilli, Stefano Tomatis, Luca Cozzi
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 86 Issue 2 Pg. 336-42 (Jun 01 2013) ISSN: 1879-355X [Electronic] United States
• PMID: 23433800 (Publication Type: Clinical Trial, Phase II, Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Feasibility Studies
• Female
• Humans
• Karnofsky Performance Status
• Liver Neoplasms (mortality, pathology, secondary, surgery)
• Male
• Middle Aged
• Prospective Studies
• Radiosurgery (adverse effects, methods, mortality)
• Radiotherapy Planning, Computer-Assisted (methods)
• Radiotherapy, Intensity-Modulated (adverse effects, methods, mortality)
• Tumor Burden