Title: Local control outcomes using stereotactic body radiation therapy for liver metastases from colorectal cancer

Publication date: Available online 31 July 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Ji Hyeon Joo, Jin-hong Park, Jin Cheon Kim, Chang Sik Yu, Seok-Byung Lim, In Ja Park., Tae Won Kim, Yong Sang Hong, Kyu-pyo Kim, Sang Min Yoon, Jongmoo Park, Jong Hoon Kim
PurposeTo evaluate the effective dose and patterns of recurrence after stereotactic body radiation therapy (SBRT) for hepatic metastases that arise from colorectal cancer.Methods and MaterialsA cohort of 70 patients with 103 colorectal liver metastases were treated with SBRT at a single institution. The prescribed doses were 45 – 60 Gy in 3–4 fractions, but these were modified based on the tolerance of the adjacent normal tissue. To allow for dose comparisons, a biological equivalent dose (BED) was calculated.ResultsThe median follow-up period was 34.2 months (range, 5.3–121.8). The 2-year overall survival and progression-free survival rates were 75% and 35%, respectively. In subgroups, the 2-year local control rates for BED ≤80 Gy (Group 1), 100-112 Gy (Group 2), and ≥ 132 Gy (Group 3) were 52%, 83%, and 89%, respectively. Cox proportional hazards model revealed a significant difference between groups (HR=0.44, P=0.03 for Group 2; HR=0.17, P=0.17 for Group 3; P=0.01 for total). The major pattern of failure was a new liver metastasis out-of the SBRT field. There was no ≥G3 toxicity.ConclusionsSBRT of liver metastases derived from colorectal cancer offers a locally effective treatment without significant complications. Longer local control can be expected if higher doses are used. Further studies will be needed to compare the efficacies of SBRT with those of surgical resection or radiofrequency ablation.

Teaser

The optimal stereotactic body radiation therapy (SBRT) dose and fractionation schedule for hepatic metastases from colorectal cancer has not yet been determined. Thus, we evaluated the effective dose by reviewing treatment results of 103 lesions. When compared with biological equivalent dose (BED), longer local control was expected if higher doses were used, with optimal BED greater than 132 Gy.


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