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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

Acknowledgement

Supported by : Korea Institute of Radiological & Medical Sciences (KIRAMS)

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