Multicenter results of stereotactic body radiotherapy (SBRT) for non-resectable primary liver tumors

Authors

  • Rafael A. Ibarra Department of Surgery, University Hospitals-Case Medical Center, Cleveland, Ohio, USA; Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Daniel Rojas Department of Surgery, University Hospitals-Case Medical Center, Cleveland, Ohio, USA;Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Laura Snyder Department of Surgery, University Hospitals-Case Medical Center, Cleveland, Ohio, USA;Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Min Yao Department of Radiation Oncology, University Hospitals-Case Medical Center, Cleveland, Ohio, USA;Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Jeffrey Fabien Department of Radiation Oncology, University Hospitals-Case Medical Center, Cleveland, Ohio, USA; Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Michael Milano University of Rochester Medical Center, Rochester, New York, USA;Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Alan Katz University of Rochester Medical Center, Rochester, New York, USA;Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Karyn Goodman Memorial Sloan-Kettering Cancer Center, New York;Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Kevin Stephans Cleveland Clinic, Case Western Reserve University & Lerner College of Medicine, Cleveland, OH; Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Galal El-Gazzaz Cleveland Clinic, Case Western Reserve University & Lerner College of Medicine, Cleveland, OH; Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Federico Aucejo Cleveland Clinic, Case Western Reserve University & Lerner College of Medicine, Cleveland, OH; Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Charles Miller Cleveland Clinic, Case Western Reserve University & Lerner College of Medicine, Cleveland, OH; Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • John Fung Cleveland Clinic, Case Western Reserve University & Lerner College of Medicine, Cleveland, OH;Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Simon Lo Department of Radiation Oncology, University Hospitals-Case Medical Center, Cleveland, Ohio, USA; Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Mitchell Machtay Department of Radiation Oncology, University Hospitals-Case Medical Center, Cleveland, Ohio, USA; Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  • Juan R. Sanabria Department of Surgery, University Hospitals-Case Medical Center, Cleveland, Ohio, USA; Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA

DOI:

https://doi.org/10.3109/0284186X.2011.652736

Abstract

Background. An excess of 100 000 individuals are diagnosed with primary liver tumors every year in USA but less than 20% of those patients are amenable to definitive surgical management due to advanced local disease or comorbidities. Local therapies to arrest tumor growth have limited response and have shown no improvement on patient survival. Stereotactic body radiotherapy (SBRT) has emerged as an alternative local ablative therapy. The purpose of this study was to evaluate the tumor response to SBRT in a combined multicenter database. Study design. Patients with advanced hepatocellular carcinoma (HCC, n = 21) or intrahepatic cholangiocarcinoma (ICC, n = 11) treated with SBRT from four Academic Medical Centers were entered into a common database. Statistical analyses were performed for freedom from local progression (FFLP) and patient survival. Results. The overall FFLP for advanced HCC was 63% at a median follow-up of 12.9 months. Median tumor volume decreased from 334.2 to 135 cm3 (p < 0.004). The median time to local progression was 6.3 months. The 1- and 2-years overall survival rates were 87% and 55%, respectively. Patients with ICC had an overall FFLP of 55.5% at a median follow-up of 7.8 months. The median time to local progression was 4.2 months and the six-month and one-year overall survival rates were 75% and 45%, respectively. The incidence of grade 1–2 toxicities, mostly nausea and fatigue, was 39.5%. Grade 3 and 4 toxicities were present in two and one patients, respectively. Conclusion. Higher rates of FFLP were achieved by SBRT in the treatment of primary liver malignancies with low toxicity.

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Published

2012-05-01

How to Cite

Ibarra, R. A., Rojas, D., Snyder, L., Yao, M., Fabien, J., Milano, M., … Sanabria, J. R. (2012). Multicenter results of stereotactic body radiotherapy (SBRT) for non-resectable primary liver tumors. Acta Oncologica, 51(5), 575–583. https://doi.org/10.3109/0284186X.2011.652736

Issue

Vol. 51 No. 5 (2012): Acta Oncologica

Section

Articles