Phase II trial on SBRT for unresectable liver metastases: long-term outcome and prognostic factors of survival after 5 years of follow-up

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Abstract

BACKGROUND: The aim of this study was to evaluate long-term efficacy and survival prognostic factors of stereotactic body radiation therapy (SBRT) for un-resectable liver metastases in patients enrolled in a prospective phase II trial.

METHODS AND MATERIALS: 5-year local control (LC), overall survival (OS), progression free survival (PFS) and toxicity rates were analyzed in patients with un-resectable liver metastases enrolled in a Phase II Trial on liver SBRT, with a prescription dose of 75Gy in 3 consecutive fractions.

RESULTS: A total of 61 patients with 76 lesions were enrolled, with a median follow-up time of 6.1 years. One, three and 5 year LC rates were 94 ± 3.1%, 78.0 ± 5.9% and 78.0 ± 5.9%, without reaching the median LC time. Median OS was 27.6 months and the survival rates were 85.2 ± 4.5%, 31.1 ± 5.9% and 18.0 ± 4.9% at 1, 3 and 5-year after SBRT, respectively. Univariate analysis showed that favorable primary site (colorectal, breast and gynecological) of metastases (p = 0.001) improved survival. Toxicity was moderate. One patient experienced G3 late chest wall pain, which resolved within 1 year from SBRT. No cases of Radiation Induced Liver Disease (RILD) were detected.

CONCLUSIONS: Long-term results of this Phase II study suggest the efficacy and safety of SBRT for un-resectable liver metastases after 5-year of follow up. Selection of cases with positive prognostic factors may improve long-term survival of these oligo-metastastic patients and may confirm the role of SBRT as an effective alternative local therapy for liver metastases.

Original languageEnglish
Pages (from-to)234
JournalRadiation Oncology
Volume13
Issue number1
DOIs
Publication statusPublished - Nov 26 2018

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Radiotherapy
Neoplasm Metastasis
Survival
Liver
Survival Rate
Thoracic Wall
Complementary Therapies
Chest Pain
Disease-Free Survival
Prescriptions
Liver Diseases
Breast
Radiation
Safety

Keywords

  • Aged
  • Dose Fractionation, Radiation
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Neoplasms/mortality
  • Male
  • Neoplasms/mortality
  • Prognosis
  • Prospective Studies
  • Radiosurgery/mortality
  • Survival Rate

Cite this

@article{3bcd7623fbc7417293d29d572b260b4b,
title = "Phase II trial on SBRT for unresectable liver metastases: long-term outcome and prognostic factors of survival after 5 years of follow-up",
abstract = "BACKGROUND: The aim of this study was to evaluate long-term efficacy and survival prognostic factors of stereotactic body radiation therapy (SBRT) for un-resectable liver metastases in patients enrolled in a prospective phase II trial.METHODS AND MATERIALS: 5-year local control (LC), overall survival (OS), progression free survival (PFS) and toxicity rates were analyzed in patients with un-resectable liver metastases enrolled in a Phase II Trial on liver SBRT, with a prescription dose of 75Gy in 3 consecutive fractions.RESULTS: A total of 61 patients with 76 lesions were enrolled, with a median follow-up time of 6.1 years. One, three and 5 year LC rates were 94 ± 3.1{\%}, 78.0 ± 5.9{\%} and 78.0 ± 5.9{\%}, without reaching the median LC time. Median OS was 27.6 months and the survival rates were 85.2 ± 4.5{\%}, 31.1 ± 5.9{\%} and 18.0 ± 4.9{\%} at 1, 3 and 5-year after SBRT, respectively. Univariate analysis showed that favorable primary site (colorectal, breast and gynecological) of metastases (p = 0.001) improved survival. Toxicity was moderate. One patient experienced G3 late chest wall pain, which resolved within 1 year from SBRT. No cases of Radiation Induced Liver Disease (RILD) were detected.CONCLUSIONS: Long-term results of this Phase II study suggest the efficacy and safety of SBRT for un-resectable liver metastases after 5-year of follow up. Selection of cases with positive prognostic factors may improve long-term survival of these oligo-metastastic patients and may confirm the role of SBRT as an effective alternative local therapy for liver metastases.",
keywords = "Aged, Dose Fractionation, Radiation, Female, Follow-Up Studies, Humans, Liver Neoplasms/mortality, Male, Neoplasms/mortality, Prognosis, Prospective Studies, Radiosurgery/mortality, Survival Rate",
author = "Marta Scorsetti and Tiziana Comito and Elena Clerici and Ciro Franzese and Angelo Tozzi and Cristina Iftode and {Di Brina}, Lucia and Pierina Navarria and Pietro Mancosu and Giacomo Reggiori and Antonella Fogliata and Stefano Tomatis and Guido Torzilli and Luca Cozzi",
year = "2018",
month = "11",
day = "26",
doi = "10.1186/s13014-018-1185-9",
language = "English",
volume = "13",
pages = "234",
journal = "Radiation Oncology",
issn = "1748-717X",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Phase II trial on SBRT for unresectable liver metastases

T2 - long-term outcome and prognostic factors of survival after 5 years of follow-up

AU - Scorsetti, Marta

AU - Comito, Tiziana

AU - Clerici, Elena

AU - Franzese, Ciro

AU - Tozzi, Angelo

AU - Iftode, Cristina

AU - Di Brina, Lucia

AU - Navarria, Pierina

AU - Mancosu, Pietro

AU - Reggiori, Giacomo

AU - Fogliata, Antonella

AU - Tomatis, Stefano

AU - Torzilli, Guido

AU - Cozzi, Luca

PY - 2018/11/26

Y1 - 2018/11/26

N2 - BACKGROUND: The aim of this study was to evaluate long-term efficacy and survival prognostic factors of stereotactic body radiation therapy (SBRT) for un-resectable liver metastases in patients enrolled in a prospective phase II trial.METHODS AND MATERIALS: 5-year local control (LC), overall survival (OS), progression free survival (PFS) and toxicity rates were analyzed in patients with un-resectable liver metastases enrolled in a Phase II Trial on liver SBRT, with a prescription dose of 75Gy in 3 consecutive fractions.RESULTS: A total of 61 patients with 76 lesions were enrolled, with a median follow-up time of 6.1 years. One, three and 5 year LC rates were 94 ± 3.1%, 78.0 ± 5.9% and 78.0 ± 5.9%, without reaching the median LC time. Median OS was 27.6 months and the survival rates were 85.2 ± 4.5%, 31.1 ± 5.9% and 18.0 ± 4.9% at 1, 3 and 5-year after SBRT, respectively. Univariate analysis showed that favorable primary site (colorectal, breast and gynecological) of metastases (p = 0.001) improved survival. Toxicity was moderate. One patient experienced G3 late chest wall pain, which resolved within 1 year from SBRT. No cases of Radiation Induced Liver Disease (RILD) were detected.CONCLUSIONS: Long-term results of this Phase II study suggest the efficacy and safety of SBRT for un-resectable liver metastases after 5-year of follow up. Selection of cases with positive prognostic factors may improve long-term survival of these oligo-metastastic patients and may confirm the role of SBRT as an effective alternative local therapy for liver metastases.

AB - BACKGROUND: The aim of this study was to evaluate long-term efficacy and survival prognostic factors of stereotactic body radiation therapy (SBRT) for un-resectable liver metastases in patients enrolled in a prospective phase II trial.METHODS AND MATERIALS: 5-year local control (LC), overall survival (OS), progression free survival (PFS) and toxicity rates were analyzed in patients with un-resectable liver metastases enrolled in a Phase II Trial on liver SBRT, with a prescription dose of 75Gy in 3 consecutive fractions.RESULTS: A total of 61 patients with 76 lesions were enrolled, with a median follow-up time of 6.1 years. One, three and 5 year LC rates were 94 ± 3.1%, 78.0 ± 5.9% and 78.0 ± 5.9%, without reaching the median LC time. Median OS was 27.6 months and the survival rates were 85.2 ± 4.5%, 31.1 ± 5.9% and 18.0 ± 4.9% at 1, 3 and 5-year after SBRT, respectively. Univariate analysis showed that favorable primary site (colorectal, breast and gynecological) of metastases (p = 0.001) improved survival. Toxicity was moderate. One patient experienced G3 late chest wall pain, which resolved within 1 year from SBRT. No cases of Radiation Induced Liver Disease (RILD) were detected.CONCLUSIONS: Long-term results of this Phase II study suggest the efficacy and safety of SBRT for un-resectable liver metastases after 5-year of follow up. Selection of cases with positive prognostic factors may improve long-term survival of these oligo-metastastic patients and may confirm the role of SBRT as an effective alternative local therapy for liver metastases.

KW - Aged

KW - Dose Fractionation, Radiation

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Liver Neoplasms/mortality

KW - Male

KW - Neoplasms/mortality

KW - Prognosis

KW - Prospective Studies

KW - Radiosurgery/mortality

KW - Survival Rate

U2 - 10.1186/s13014-018-1185-9

DO - 10.1186/s13014-018-1185-9

M3 - Article

C2 - 30477560

VL - 13

SP - 234

JO - Radiation Oncology

JF - Radiation Oncology

SN - 1748-717X

IS - 1

ER -