TY  - BOOK
AU  - Perry, David J
TI  - Stereotactic Body Radiotherapy (SBRT) for liver metastasis - clinical outcomes from the international multi-institutional RSSearch Patient Registry
SN  - 1748-717X
PY  - 2018///
KW  - *Liver Neoplasms/sc [Secondary]
KW  - *Liver Neoplasms/su [Surgery]
KW  - *Radiosurgery
KW  - *Registries/sn [Statistics & Numerical Data]
KW  - Adult
KW  - Aged
KW  - Aged, 80 and over
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - International Agencies
KW  - Male
KW  - Middle Aged
KW  - Prognosis
KW  - Radiotherapy Dosage
KW  - Retrospective Studies
KW  - Survival Rate
KW  - Washington Cancer Institute
KW  - Journal Article
N2  - BACKGROUND: Stereotactic body radiotherapy (SBRT) is an emerging treatment option for liver metastases in patients unsuitable for surgery. We investigated factors associated with clinical outcomes for liver metastases treated with SBRT from a multi-center, international patient registry; CONCLUSIONS: In a large, multi-institutional series of patients with liver metastasis treated with SBRT, reasonable LC and OS was observed. OS and LC depended on dose and tumor volume, while OS varied by primary tumor. Future prospective trials on the role of SBRT for liver metastasis from different primaries in the setting of multidisciplinary management including systemic therapy, is warranted; METHODS: Patients with liver metastases treated with SBRT were identified in the RSSearch Patient Registry. Patient, tumor and treatment characteristics associated with treatment outcomes were assessed. Dose fractionations were normalized to BED<sub>10</sub>. Overall survival (OS) and local control (LC) were evaluated using Kaplan Meier analysis and log-rank test; RESULTS: The study included 427 patients with 568 liver metastases from 25 academic and community-based centers. Median age was 67 years (31-91 years). Colorectal adenocarcinoma (CRC) was the most common primary cancer. 73% of patients received prior chemotherapy. Median tumor volume was 40 cm<sup>3</sup> (1.6-877 cm<sup>3</sup>), median SBRT dose was 45 Gy (12-60 Gy) delivered in a median of 3 fractions [1-5]. At a median follow-up of 14 months (1-91 months) the median overall survival (OS) was 22 months. Median OS was greater for patients with CRC (27 mo), breast (21 mo) and gynecological (25 mo) metastases compared to lung (10 mo), other gastro-intestinal (GI) (18 mo) and pancreatic (6 mo) primaries (p<0.0001). Smaller tumor volumes (<40 cm<sup>3</sup>) correlated with improved OS (25 months vs 15 months p=0.0014). BED<sub>10</sub>>=100 Gy was also associated with improved OS (27 months vs 15 months p<0.0001). Local control (LC) was evaluable in 430 liver metastases from 324 patients. Two-year LC rates was better for BED<sub>10</sub>>=100 Gy (77.2% vs 59.6%) and the median LC was better for tumors <40 cm<sup>3</sup> (52 vs 39 months). There was no difference in LC based on histology of the primary tumor; TRIAL REGISTRATION: Clinicaltrials.gov: NCT01885299
UR  - https://dx.doi.org/10.1186/s13014-018-0969-2
ER  -