Radiat Oncol J.  2017 Jun;35(2):172-179. 10.3857/roj.2017.00024.

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

Affiliations
  • 1Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea. mskim@kirams.re.kr

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 ≥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.

Keyword

Liver metastases; Oligo-recurrence; Oligo-progression; Stereotactic radiation therapy

MeSH Terms

Colon
Disease-Free Survival
Fatigue
Follow-Up Studies
Humans
Liver*
Nausea
Neoplasm Metastasis
Stomach
Survival Rate
Tumor Burden
Vomiting
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