Journal article
Stereotactic Body Radiotherapy for Colorectal Liver Metastases A Pooled Analysis
Cancer, Vol.117(17), pp.4060-4069
09/01/2011
DOI: 10.1002/cncr.25997
PMID: 21432842
Abstract
BACKGROUND: This study was undertaken to determine outcomes of stereotactic body radiotherapy for colorectal liver metastases in a pooled patient cohort. METHODS: Patients with colorectal liver metastases from 3 institutions were included if they had 1 to 4 lesions, received 1 to 6 fractions of stereotactic body radiotherapy, and had radiologic imaging >= 3 months post-treatment. Sixty-five patients with 102 lesions treated from August 2003 to May 2009 were retrospectively analyzed. A tumor control probability (TCP) model was used to estimate the 3-fraction dose required for >90% local control after converting the schedule into biologically equivalent dose (BED), single-fraction equivalent dose, or linear quadratic model-based single-fraction dose. RESULTS: Forty-seven (72%) patients had >= 1 chemotherapy regimen before stereotactic body radiotherapy, and 27 (42%) patients had >= 2 regimens. The median follow-up was 1.2 years (range, 0.3-5.2 years). The median dose was 42 gray (Gy; range, 22-60 Gy). When evaluated separately by multivariate analysis, total dose (P = .0015), dose/fraction (P = .003), and BED (P = .004) all correlated with local control by lesion. On multivariate analysis, nonactive extrahepatic disease was associated with overall survival (OS; P = .046), and sustained local control was closely correlated (P = .06). By using single-fraction equivalent dose, BED, or linear quadratic model-based single-fraction dose in the TCP model, the estimated dose range needed for 1-year local control >90% is 46 to 52 Gy in 3 fractions. CONCLUSIONS: Liver stereotactic body radiotherapy is well tolerated and effective for colorectal liver metastases. The strong correlation between local control and OS supports controlling hepatic disease even for heavily pretreated patients. For a 3-fraction regimen of stereotactic body radiotherapy, a prescription dose of >= 48 Gy should be considered, if normal tissue constraints allow. Cancer 2011;117:4060-9. (C) 2011 American Cancer Society.
Details
- Title: Subtitle
- Stereotactic Body Radiotherapy for Colorectal Liver Metastases A Pooled Analysis
- Creators
- Daniel T. Chang - Stanford UniversityAnand Swaminath - Department of Radiation Oncology Princess Margaret Hospital, University of Toronto Toronto Ontario CanadaMargaret Kozak - Stanford UniversityJulie Weintraub - University of Colorado DenverAlbert C. Koong - Stanford UniversityJohn Kim - University of TorontoRob Dinniwell - Department of Radiation Oncology Princess Margaret Hospital, University of Toronto Toronto Ontario CanadaJames Brierley - Department of Radiation Oncology Princess Margaret Hospital, University of Toronto Toronto Ontario CanadaBrian D. Kavanagh - University of Colorado DenverLaura A. Dawson - Department of Radiation Oncology Princess Margaret Hospital, University of Toronto Toronto Ontario CanadaTracey E. Schefter - University of Colorado Denver
- Resource Type
- Journal article
- Publication Details
- Cancer, Vol.117(17), pp.4060-4069
- Publisher
- Wiley
- DOI
- 10.1002/cncr.25997
- PMID
- 21432842
- ISSN
- 0008-543X
- eISSN
- 1097-0142
- Number of pages
- 10
- Grant note
- Bayer; Bayer AG
- Language
- English
- Date published
- 09/01/2011
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9984312965902771
Metrics
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