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• W2047873273 abstract "Purpose: The prevalence of liver metastases is very high for patients whose primary diagnosis are colorectal, pancreas, lung, and breast cancer. Local control of the disease may increase both quality of life and survival. The aim of this study to show feasibility, efficiency, and low morbidity combined with a high local control probability in use of robotic stereotactic body radiation therapy (rSBRT) treatment for liver metastases. Methods and Materials: A total of 55 patients with 84 liver metastases from different primary sites who underwent rSBRT in our center between July 2006 and December 2011 were reviewed for this study. Patients who refused surgery or judged inoperable were included in this study. Patients were required to have adequate liver function and more than three months minimum life expectancy. An average of three (3-5) fiducial markers were implanted percutaneously under CT-guidance with local anaesthesia. Maximum three liver metastases from any primary sites were treated and accepted for this study. Treatment planning CT, magnetic resonance imaging (MRI), and positron emission tomography-CT (PET-CT) were used for tumor delination. Treatment plan dose was prescribed at the PTV with an isodose line range 70-85% which was covering the 95% volume of PTV. We mandated that minumum 700 cc of normal liver had to receive at total dose less than 15 Gy in three to five fractions. The patients were examined every three months after rSBRT by biochemical examinations and imaging. PET-CT or MRI were performed at each follow-up. Results: Fifty-five patients (32 males, 23 females) who had liver metastases from various primary sites were treated with rSBRT using real-time tumor tracking system. Mean age of patients was 61 years (range 22 to 86 years). The primary sites included colorectal (n=23), pancreas (n=8), breast (n=7), lung (n=6), bladder (n=3), and others (n=8). The total prescribed dose was 45 Gy (range 24 Gy to 45 Gy) in median 3 (range three to six) fractions. The minimum normal liver volume (700 cc) was received mean 7.8 Gy (range 2 Gy to 14.6 Gy). Forty-nine (89%) patients were evaluated for tumor response, local control and survival analysis. The median follow-up was 12 months (range four to 39 months). CR was seen in 25 (51%) patients, PR in 12 (25%) patients, and SD in two (4%) patients at first follow-up. Ten (10%) patients had progressed inside the treated volume at first follow-up. The actuarial local control rate for patients is shown in Figure 2. The actuarial one-year and two-year local control rates were 61% (95% confidence interval (CI), 53%-69%) and 39% (95% CI, 28%-49%), respectively. The median overall survival was 16 months. The actuarial one-year and two-year overall survival rates were 79% (95% (CI), 73%-85%) and 56% (95% CI, 48%-63%), respectively. Conclusion: The results of our study have show that rSBRT for the treatment of liver metastases is feasible and safe with minimal side-effects. Further studies are required with larger patient series to compare rSBRT with other local ablative techniques and systemic therapies." @default.
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• W2047873273 date "2012-12-11" @default.
• W2047873273 modified "2023-09-27" @default.
• W2047873273 title "Robotic Radiosurgery for Liver Metastases" @default.
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• W2047873273 doi "https://doi.org/10.7759/cureus.77" @default.
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