DOI QR코드

DOI QR Code

Stereotactic body radiation therapy for liver oligo-recurrence and oligo-progression from various tumors

  • Cha, Yu Jin (Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences) ;
  • Kim, Mi-Sook (Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences) ;
  • Jang, Won-Il (Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences) ;
  • Seo, Young Seok (Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences) ;
  • Cho, Chul Koo (Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences) ;
  • Yoo, Hyung Jun (Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences) ;
  • Paik, Eun Kyung (Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences)
  • Received : 2017.01.10
  • Accepted : 2017.06.02
  • Published : 2017.06.30

Abstract

Purpose: To evaluate the outcomes of stereotactic body radiation therapy (SBRT) for patients with liver oligo-recurrence and oligo-progression from various primary tumors. Materials and Methods: Between 2002 and 2013, 72 patients with liver oligo-recurrence (oligo-metastasis with a controlled primary tumor) and oligo-progression (contradictory progression of a few sites of disease despite an overall tumor burden response to therapy) underwent SBRT. Of these, 9 and 8 patients with uncontrollable distant metastases and patients immediate loss to follow-up, respectively, were excluded. The total planning target volume was used to select the SBRT dose (median, 48 Gy; range, 30 to 60 Gy, 3-4 fractions). Toxicity was evaluated using the Common Toxicity Criteria for Adverse Events v4.0. Results: We evaluated 55 patients (77 lesions) treated with SBRT for liver metastases. All patients had controlled primary lesions, and 28 patients had stable lesions at another site (oligo-progression). The most common primary site was the colon (36 patients), followed by the stomach (6 patients) and other sites (13 patients). The 2-year local control and progression-free survival rates were 68% and 22%, respectively. The 2- and 5-year overall survival rates were 56% and 20%, respectively. The most common adverse events were grade 1-2 fatigue, nausea, and vomiting; no grade ${\geq}3$ toxicities were observed. Univariate analysis revealed that oligo-progression associated with poor survival. Conclusion: SBRT for liver oligo-recurrence and oligo-progression appears safe, with similar local control rates. For liver oligo-progression, criteria are needed to select patients in whom improved overall survival can be expected through SBRT.

Keywords

References

  1. Kasper HU, Drebber U, Dries V, Dienes HP. Liver metastases: incidence and histogenesis. Z Gastroenterol 2005;43:1149-57.
  2. Robertson DJ, Stukel TA, Gottlieb DJ, Sutherland JM, Fisher ES. Survival after hepatic resection of colorectal cancer metastases: a national experience. Cancer 2009;115:752-9. https://doi.org/10.1002/cncr.24081
  3. Haddad AJ, Bani Hani M, Pawlik TM, Cunningham SC. Colorectal liver metastases. Int J Surg Oncol 2011;2011:285840.
  4. Biasco G, Derenzini E, Grazi G, et al. Treatment of hepatic metastases from colorectal cancer: many doubts, some certainties. Cancer Treat Rev 2006;32:214-28. https://doi.org/10.1016/j.ctrv.2005.12.011
  5. Dawood O, Mahadevan A, Goodman KA. Stereotactic body radiation therapy for liver metastases. Eur J Cancer 2009;45:2947-59. https://doi.org/10.1016/j.ejca.2009.08.011
  6. Kim MS, Kim W, Park IH, et al. Radiobiological mechanisms of stereotactic body radiation therapy and stereotactic radiation surgery. Radiat Oncol J 2015;33:265-75. https://doi.org/10.3857/roj.2015.33.4.265
  7. Folkert MR, Timmerman RD. Stereotactic ablative body radiosurgery (SABR) or stereotactic body radiation therapy (SBRT). Adv Drug Deliv Rev 2017;109:3-14. https://doi.org/10.1016/j.addr.2016.11.005
  8. Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol 1995;13:8-10. https://doi.org/10.1200/JCO.1995.13.1.8
  9. Niibe Y, Hayakawa K. Oligometastases and oligo-recurrence: the new era of cancer therapy. Jpn J Clin Oncol 2010;40:107-11. https://doi.org/10.1093/jjco/hyp167
  10. Seo YS, Kim MS, Yoo HJ, Jang WI. Stereotactic body radiotherapy for oligo-recurrence within the nodal area from colorectal cancer. World J Gastroenterol 2014;20:2005-13. https://doi.org/10.3748/wjg.v20.i8.2005
  11. Cheung P. Stereotactic body radiotherapy for oligoprogressive cancer. Br J Radiol 2016;89:20160251. https://doi.org/10.1259/bjr.20160251
  12. Westover KD, Iyengar P, Sharma AN, Timmerman R. SABR for aggressive local therapy of metastatic cancer: a new paradigm for metastatic non-small cell lung cancer. Lung Cancer 2015;89:87-93. https://doi.org/10.1016/j.lungcan.2015.04.009
  13. Reyes DK, Pienta KJ. The biology and treatment of oligometastatic cancer. Oncotarget 2015;6:8491-524.
  14. Eccles CL, Patel R, Simeonov AK, Lockwood G, Haider M, Dawson LA. Comparison of liver tumor motion with and without abdominal compression using cine-magnetic resonance imaging. Int J Radiat Oncol Biol Phys 2011;79:602-8. https://doi.org/10.1016/j.ijrobp.2010.04.028
  15. Fowler JF. The linear-quadratic formula and progress in fractionated radiotherapy. Br J Radiol 1989;62:679-94. https://doi.org/10.1259/0007-1285-62-740-679
  16. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000;92:205-16. https://doi.org/10.1093/jnci/92.3.205
  17. Rusthoven KE, Kavanagh BD, Cardenes H, et al. Multiinstitutional phase I/II trial of stereotactic body radiation therapy for liver metastases. J Clin Oncol 2009;27:1572-8. https://doi.org/10.1200/JCO.2008.19.6329
  18. van der Pool AE, Mendez Romero A, Wunderink W, et al. Stereotactic body radiation therapy for colorectal liver metastases. Br J Surg 2010;97:377-82. https://doi.org/10.1002/bjs.6895
  19. Lee MT, Kim JJ, Dinniwell R, et al. Phase I study of individualized stereotactic body radiotherapy of liver metastases. J Clin Oncol 2009;27:1585-91. https://doi.org/10.1200/JCO.2008.20.0600
  20. Yamashita H, Onishi H, Matsumoto Y, et al. Local effect of stereotactic body radiotherapy for primary and metastatic liver tumors in 130 Japanese patients. Radiat Oncol 2014;9:112. https://doi.org/10.1186/1748-717X-9-112
  21. Andratschke NH, Nieder C, Heppt F, Molls M, Zimmermann F. Stereotactic radiation therapy for liver metastases: factors affecting local control and survival. Radiat Oncol 2015;10:69. https://doi.org/10.1186/s13014-015-0369-9
  22. Berber B, Ibarra R, Snyder L, et al. Multicentre results of stereotactic body radiotherapy for secondary liver tumours. HPB (Oxford) 2013;15:851-7. https://doi.org/10.1111/hpb.12044
  23. Klement RJ, Guckenberger M, Alheid H, et al. Stereotactic body radiotherapy for oligo-metastatic liver disease: influence of pre-treatment chemotherapy and histology on local tumor control. Radiother Oncol 2017;123:227-33. https://doi.org/10.1016/j.radonc.2017.01.013
  24. Ahmed KA, Fulp WJ, Berglund AE, et al. Differences between colon cancer primaries and metastases using a molecular assay for tumor radiation sensitivity suggest implications for potential oligometastatic SBRT patient selection. Int J Radiat Oncol Biol Phys 2015;92:837-42. https://doi.org/10.1016/j.ijrobp.2015.01.036
  25. Rule W, Timmerman R, Tong L, et al. Phase I dose-escalation study of stereotactic body radiotherapy in patients with hepatic metastases. Ann Surg Oncol 2011;18:1081-7. https://doi.org/10.1245/s10434-010-1405-5
  26. Vautravers-Dewas C, Dewas S, Bonodeau F, et al. Imageguided robotic stereotactic body radiation therapy for liver metastases: is there a dose response relationship? Int J Radiat Oncol Biol Phys 2011;81:e39-47. https://doi.org/10.1016/j.ijrobp.2010.12.047
  27. Aitken KL, Tait DM, Nutting CM, Khabra K, Hawkins MA. Riskadapted strategy partial liver irradiation for the treatment of large volume metastatic liver disease. Acta Oncol 2014;53:702-6. https://doi.org/10.3109/0284186X.2013.862595
  28. Takeda A, Sanuki N, Tsurugai Y, Oku Y, Aoki Y. Stereotactic body radiotherapy for patients with oligometastases from colorectal cancer: risk-adapted dose prescription with a maximum dose of 83-100 Gy in five fractions. J Radiat Res 2016;57:400-5. https://doi.org/10.1093/jrr/rrw029
  29. Kinj R, Bondiau PY, Francois E, et al. Radiosensitivity of colon and rectal lung oligometastasis treated with stereotactic ablative radiotherapy. Clin Colorectal Cancer 2016 Aug 31 [Epub]. http://doi.org/10.1016/j.clcc.2016.08.003.

Cited by

  1. Feasibility of split-course stereotactic ablative radiotherapy for oligometastases vol.48, pp.6, 2018, https://doi.org/10.1093/jjco/hyy062
  2. Comparison of stereotactic body radiotherapy versus metastasectomy outcomes in patients with pulmonary metastases vol.9, pp.12, 2018, https://doi.org/10.1111/1759-7714.12880