The SBRT database initiative of the German Society for Radiation Oncology (DEGRO): patterns of care and outcome analysis of stereotactic body radiotherapy (SBRT) for liver oligometastases in 474 patients with 623 metastases

Andratschke, Nicolaus; Alheid, H.; Allgäuer, Michael; Becker, Gerd; Blanck, Oliver; Boda-Heggemann, Judit; Brunner, Thomas; Duma, Marciana-Nona; Gerum, S.; Gückenberger, Matthias; Hildebrandt, Guido; Klement, Rainer J.; Lewitzki, V.; Ostheimer, C.; Papachristofilou, Alexandros; Petersen, Cordula; Schneider, T.; Semrau, R.; Wachter, Stefan De; Habermehl, Daniel

doi:10.1186/s12885-018-4191-2

Cited by 127 publications

(114 citation statements)

References 29 publications

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“…The achieved one-year LC of 62.5% is slightly lower, while the one-year LC of 87.5% for patients with colorectal cancer is in line with the results of local control from other studies, ranging from 71 to 95% [26,27,[29][30][31]. This study showed that there was a signi cant difference in local control in patients with colorectal cancer compared to other histologies (87.5% vs 37.5%, p=0.014).…”

Section: Discussionsupporting

confidence: 89%

“…No signi cant difference in one-year survival was achieved between the observed groups (p=0.147). The results of other studies range from 68.6% to 83.5% [28][29][30][31]. Rusthoven et al showed that there was a group of favorable histologies, which include colorectal cancer, breast and kidney cancer, carcinoids, GIST and sarcomas, which has a signi cantly longer mean survival of 32 months compared to other adverse histologies with a mean survival of 12 months (p=0.001) [26].…”

Section: Discussionmentioning

confidence: 97%

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Stereotactic Body Radiation Therapy (SBRT) for Liver Oligometastases: outcomes and safety

Cazic¹,

Marosevic²

2020

Preprint

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Background: The aim of this study was to investigate adverse effects, progression free survival (PFS), one-year local control (LC) and one-year overall survival (OS) of patients with liver oligometastases treated with stereotactic body radiotherapy (SBRT), and whether there is a significant difference in these parameters in patients with primary colorectal cancer compared to other tumor localizations.Methods: Patients were simulated using four-dimensional computed tomography (4DCT). Using volumetric modulated arc therapy (VMAT) technique, SBRT was performed on 16 patients with <3 liver metastases. The prescribed dose was 60 Gy in 8 fractions (BED 105 Gy). Cone beam CT (CBCT) was used for image guidance before each fraction with online correction.Results: There were no adverse effects. Mean PFS for all patients, patients with primary colorectal cancer, and patients with primary non-colorectal cancer was 12.2 months (SD 8.3), 16.3 months (SD 7.9), 8.1 months (SD 6.8), respectively. There was a significant difference in the mean PFS for these two observed groups (p = 0.023). The one-year LC was 62.5%. Patients with primary colorectal cancer had the one-year LC of 87.5%, while the group of patients with primary non-colorectal cancer had the one-year LC of 37.5% (p = 0.014). The total one-year OS was 87.5%. In the group of patients with primary colorectal cancer, the one-year OS was 100%, while in the group of patients with primary non-colorectal cancer, the one-year OS was 75% (p = 0.147).Conclusion: SBRT is a safe and effective method of treating liver oligometastases.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 97%

Stereotactic Body Radiation Therapy (SBRT) for Liver Oligometastases: outcomes and safety

Cazic¹,

Marosevic²

2020

Preprint

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“…Indeed, Zhao et al reported that a larger GTV volume significantly correlated with inferior LC following adrenal SBRT [41]. Similar to pulmonary and hepatic SBRT, a clear doseresponse relationship is also expected for the treatment of adrenal gland metastases [17,42]. Chance et al recently reported no local failures following adrenal SBRT with a BED 10 > 100 Gy [26].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to conventionally fractionated radiotherapy, SBRT allows for the delivery of highly conformal doses or radiation, enabling tumor ablation. While SBRT is well established and widely applied in the treatment of pulmonary and hepatic oligometastases [17][18][19][20], the literature for adrenal metastases is scarce. Predominantly small and retrospective studies exist which do not primarily focus on oligometastatic or oligoprogressive disease, but also include patients treated with palliative intent [21][22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Stereotactic body radiotherapy (SBRT) for adrenal metastases of oligometastatic or oligoprogressive tumor patients

et al. 2020

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Introduction: Local ablative treatment strategies are frequently offered to patients diagnosed with oligometastatic disease. Stereotactic body radiotherapy (SBRT), as ablative treatment option, is well established for lung and liver metastases, whereas for isolated adrenal gland metastases the level of evidence is scarce. Material and methods: This single-institution analysis of oligometastatic or oligoprogressive disease was limited to patients who received SBRT to adrenal metastasis between 2012 and 2019. Patient, tumor, treatment characteristics, and dosimetric parameters were analyzed for evaluation of their effect on survival outcomes. Results: During the period of review 28 patients received ablative SBRT to their adrenal gland metastases. Most common primary tumors were non-small cell lung cancers (46%) with most patients diagnosed with a single adrenal gland metastasis (61%), which occurred after a median time of 14 months. SBRT was delivered to a median biological effective dose at α/β of 10 (BED 10) of 75 Gy (range: 58-151 Gy). Median gross tumor volume (GTV) and median planning target volume (PTV) were 42 and 111 mL, respectively. The homogeneity and conformity indices were 1.17 (range: 1.04-1.64) and 0.5 (range: 0.4.0.99), respectively, with the conformity index being affected by dose restrictions to organs at risk (OARs) in 50% of the patients. Overall response rate based on RECIST criteria was 86% (CR = 29%, PR = 57%) with 2-year local control (LC) of 84.8%, 2-year progression-free survival (PFS) of 26.3%, and 1and 2-year overall survival (OS) of 46.6 and 32.0%, respectively. During follow up, only two local recurrences occurred. A trend for superior LC was seen if BED 10 was ≥75Gy (p = 0.101) or if the PTV was < 100 ml (p = 0.072). SBRT was tolerated well with only mild toxicity. Conclusion: SBRT for adrenal metastases resulted in promising LC with low toxicity. Treatment response appeared to be superior, if SBRT was applied with higher BED. As the close proximity of OARs often limits the application of sufficiently high doses, further dose escalations strategies and techniques should be investigated in future.

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“…With the introduction of image guidance and conformal radiotherapy techniques, the treatment of both primary and secondary liver tumours has experienced significant improvement over the past few years, leading to increased local control rates and decreased normal tissue toxicity [14][15][16][17][18][19].…”

Section: Indications For Radiotherapymentioning

confidence: 99%

Radiomics for liver tumours

et al. 2020

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Current research, especially in oncology, increasingly focuses on the integration of quantitative, multiparametric and functional imaging data. In this fast-growing field of research, radiomics may allow for a more sophisticated analysis of imaging data, far beyond the qualitative evaluation of visible tissue changes. Through use of quantitative imaging data, more tailored and tumour-specific diagnostic work-up and individualized treatment concepts may be applied for oncologic patients in the future. This is of special importance in cross-sectional disciplines such as radiology and radiation oncology, with already high and still further increasing use of imaging data in daily clinical practice. Liver targets are generally treated with stereotactic body radiotherapy (SBRT), allowing for local dose escalation while preserving surrounding normal tissue. With the introduction of online target surveillance with implanted markers, 3D-ultrasound on conventional linacs and hybrid magnetic resonance imaging (MRI)-linear accelerators, individualized adaptive radiotherapy is heading towards realization. The use of big data such as radiomics and the integration of artificial intelligence techniques have the potential to further improve image-based treatment planning and structured follow-up, with outcome/toxicity prediction and immediate detection of (oligo)progression. The scope of current research in this innovative field is to identify and critically discuss possible application forms of radiomics, which is why this review tries to summarize current knowledge about interdisciplinary integration of radiomics in oncologic patients, with a focus on investigations of radiotherapy in patients with liver cancer or oligometastases including multiparametric, quantitative data into (radio)-oncologic workflow from disease diagnosis, treatment planning, delivery and patient follow-up.

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The SBRT database initiative of the German Society for Radiation Oncology (DEGRO): patterns of care and outcome analysis of stereotactic body radiotherapy (SBRT) for liver oligometastases in 474 patients with 623 metastases

Cited by 127 publications

References 29 publications

Stereotactic Body Radiation Therapy (SBRT) for Liver Oligometastases: outcomes and safety

Stereotactic Body Radiation Therapy (SBRT) for Liver Oligometastases: outcomes and safety

Stereotactic body radiotherapy (SBRT) for adrenal metastases of oligometastatic or oligoprogressive tumor patients

Radiomics for liver tumours

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