Stereotactic body radiation therapy for colorectal liver metastases

Pool, Anne E. M. van der; Romero, Alejandra Méndez; Wunderink, Wouter; Heijmen, B.; Levendag, Peter C.; Verhoef, Cornelis; IJzermans, Jan N.M.

doi:10.1002/bjs.6895

Cited by 153 publications

(78 citation statements)

References 32 publications

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“…22 In 2010, our group reported a 74% local control rate at 2 years in a group of patients treated mainly with 37.5 Gy delivered at the 65-67% isodose surrounding the PTV. 5 Two episodes of asymptomatic elevation of GGT and one asthenia grade 3 were observed. In our present series, 2 and 3 year local control rates were 74 and 66% for 37.5 Gy and 90 and 81% for 50.25 Gy.…”

Section: Discussionmentioning

confidence: 97%

“…Details about this procedure have been reported earlier. 5,[11][12][13] From 2011, only one large contrast enhanced planning CT in the venous phase was acquired. The tumor delineations have always been reviewed by an experienced radiologist.…”

Section: Treatment Preparation and Deliverymentioning

confidence: 99%

“…As described in a previous paper, one patient developed a portal hypertension syndrome with esophageal varices and one episode of melena after two SBRT treatments. 5,13 A case of a biliary tree dilatation was observed in a patient treated for a centrally located liver metastases with 50.25 Gy.…”

Section: Toxicitymentioning

confidence: 99%

“…High local control rates at 2 years of 74-91% and median survival of 34 months have been reported after SBRT for colorectal liver metastases. 5,6 A few studies have assessed the role of dose escalation on the clinical outcomes after SBRT for liver metastases. In 2006 Wulf et al found a significant improvement in 2 year local control (82 vs. 58%) with 12-12.5 Gy in 3 fractions or 26 Gy in 1 fraction vs. 30 Gy in 3 fractions.…”

Section: Introductionmentioning

confidence: 99%

“…10 In 2010, our group reported a 2-year local control of 74% for patients with colorectal liver metastases treated mainly with 37.5 Gy in 3 fractions. 5 Later on, and based on published data, the dose was escalated to 50.25 Gy also delivered in 3 fractions. This retrospective study investigated whether the increase in dose represented an improvement in local control without raising the treatment associated toxicity in our patient population.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Institutional experience in the treatment of colorectal liver metastases with stereotactic body radiation therapy

Romero

Keskin-Cambay

et al. 2017

Reports of Practical Oncology & Radiotherapy

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Metastases LiverStereotactic body radiation therapy a b s t r a c t Aim: To investigate whether the impact of dose escalation in our patient population represented an improvement in local control without increasing treatment related toxicity. Materials and methods:A cohort of consecutive patients with colorectal liver metastases treated with stereotactic body radiation therapy (SBRT) between December 2002 and December 2013 were eligible for this study. Inclusion criteria were a Karnofsky performance status ≥80% and, according to the multidisciplinary tumor board, ineligibility for surgery or radiofrequency ablation. Exclusion criteria were a lesion size >6 cm, more than 3 metastases, and treatment delivered with other fractionation scheme than 3 times 12.5 Gy or 16.75 Gy prescribed at the 65-67% isodose. To analyze local control, CT or MRI scans were acquired during follow-up. Toxicity was scored using the Common Toxicity Criteria Adverse Events v4.0.Results: A total of 40 patients with 55 colorectal liver metastases were included in this study.We delivered 37.5 Gy to 32 lesions, and 50.25 Gy to 23 lesions. Median follow-up was 26 and 25 months for these two groups. Local control at 2 and 3 years was 74 and 66% in the low dose group while 90 and 81% was reached in the high dose group. No significant difference in local control between the two dose fractionation schemes could be found. Grade 3 toxicity was limited and was not increased in the high dose group.Conclusions: SBRT for colorectal liver metastases offers a high chance of local control at long term. High irradiation doses may contribute to enhance this effect without increasing toxicity.

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Section: Discussionmentioning

confidence: 97%