Liver SBRT with active motion-compensation results in excellent local control for liver oligometastases

• Verfasst von: Stera, Susanne [VerfasserIn]
• Verfasst von: Miebach, Georgia [VerfasserIn]
• Verfasst von: Bürgy, Daniel [VerfasserIn]
• Verfasst von: Dreher, Constantin [VerfasserIn]
• Verfasst von: Lohr, Frank [VerfasserIn]
• Verfasst von: Wurster, Stefan [VerfasserIn]
• Verfasst von: Rödel, Claus [VerfasserIn]
• Verfasst von: Marcella, Szücs [VerfasserIn]
• Verfasst von: Krug, David [VerfasserIn]
• Verfasst von: Frank A., Giordano [VerfasserIn]
• Verfasst von: Ehmann, Michael [VerfasserIn]
• Verfasst von: Fleckenstein, Jens [VerfasserIn]
• Verfasst von: Blanck, Oliver [VerfasserIn]
• Verfasst von: Boda-Heggemann, Judit [VerfasserIn]
• Titel: Liver SBRT with active motion-compensation results in excellent local control for liver oligometastases
• Titelzusatz: an outcome analysis of a pooled multi-platform patient cohort
• Verf.angabe: Susanne Stera, Georgia Miebach, Daniel Buergy, Constantin Dreher, Frank Lohr, Stefan Wurster, Claus Rödel, Szücs Marcella, David Krug, Giordano Frank A., Michael Ehmann, Jens Fleckenstein, Oliver Blanck, Judit Boda-Heggemann
• E-Jahr: 2021
• Jahr: May 2021
• Umfang: 7 S.
• Fussnoten: Gesehen am 17.09.2021
• Titel Quelle: Enthalten in: Radiotherapy and oncology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1983
• Jahr Quelle: 2021
• Band/Heft Quelle: 158(2021) vom: Mai, Seite 230-236
• ISSN Quelle: 1879-0887
• DOI: doi:10.1016/j.radonc.2021.02.036
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Active motion management
• Sach-SW: CyberKnife
• Sach-SW: Deep inspiration breath hold
• Sach-SW: Liver SBRT
• Sach-SW: Robotic tracking
• K10plus-PPN: 1770893083

Abstract

Background - Local treatment of metastases in combination with systemic therapy can prolong survival of oligo-metastasized patients. To fully exploit this potential, safe and effective treatments are needed to ensure long-term metastases control. Stereotactic body radiotherapy (SBRT) is one means, however, for moving liver tumors correct delivery of high doses is challenging. After validating equal in-vivo treatment accuracy, we analyzed a pooled multi-platform liver-SBRT-database for clinical outcome. - Methods - Local control (LC), progression-free interval (PFI), overall survival (OS), predictive factors and toxicity was evaluated in 135 patients with 227 metastases treated by gantry-based SBRT (deep-inspiratory breath-hold-gating; n = 71) and robotic-based SBRT (fiducial-tracking, n = 156) with mean gross tumor volume biological effective dose (GTV-BEDα/β=10Gy) of 146.6 Gy10. - Results - One-, and five-year LC was 90% and 68.7%, respectively. On multivariate analysis, LC was significantly predicted by colorectal histology (p = 0.006). Median OS was 20 months with one- and two-year OS of 67% and 37%. On multivariate analysis, ECOG-status (p = 0.003), simultaneous chemotherapy (p = 0.003), time from metastasis detection to SBRT-treatment (≥2months; p = 0.021) and LC of the treated metastases (≥12 months, p < 0.009) were significant predictors for OS. One- and two-year PFI were 30.5% and 14%. Acute toxicity was mild and rare (14.4% grade I, 2.3% grade II, 0.6% grade III). Chronic °III/IV toxicities occurred in 1.1%. - Conclusions - Patient selection, time to treatment and sufficient doses are essential to achieve optimal outcome for SBRT with active motion compensation. Local control appears favorable compared to historical control. Long-term LC of the treated lesions was associated with longer overall survival.