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Stereotactic body radiation therapy using the CyberKnife(®) system for patients with liver metastases.

Yuan ZY, Meng MB, Liu CL, Wang HH, Jiang C, Song YC, Zhuang HQ, Yang D, Wang JS, Wei W, Li FT, Zhao LJ, Wang P - Onco Targets Ther (2014)

Bottom Line: Secondary endpoints were overall survival, progression-free survival, distant progression-free survival, and adverse events.The 2-year overall survival rate was 72.2% in the favorable group (primary tumors originating from the colon, breast, or stomach, as well as sarcomas); however, in the unfavorable group (primary tumors originating from the pancreas, lung, ovary, gallbladder, uterus, hepatocellular carcinoma, as well as olfactory neuroblastoma), the median overall survival and 2-year overall survival rates were 37.5 months and 55.9%, respectively (P=0.0001).Grade 1-2 fatigue, nausea, and vomiting were the most common adverse events, and no grade 3 and higher adverse events were observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, CyberKnife Center, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin, People's Republic of China.

ABSTRACT
The aim of this study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) in the treatment of patients with liver metastases. Between August 2006 and July 2011, patients with 1-4 liver metastases were enrolled and treated with SBRT using the CyberKnife(®) system at Tianjin Medical University Cancer Institute and Hospital. The metastases were from different primary tumors, with a maximum tumor diameter of less than 6 cm. The primary endpoint was local control. Secondary endpoints were overall survival, progression-free survival, distant progression-free survival, and adverse events. Fifty-seven patients with 80 lesions were treated with SBRT. The 1-year and 2-year local control rates were 94.4% and 89.7%, respectively. The difference in local control between patients who received adjuvant treatment before SBRT and those who did not reached statistical significance (P=0.049). The median overall survival for the entire cohort was 37.5 months. According to the primary tumor sites, the median overall survival was not reached. The 2-year overall survival rate was 72.2% in the favorable group (primary tumors originating from the colon, breast, or stomach, as well as sarcomas); however, in the unfavorable group (primary tumors originating from the pancreas, lung, ovary, gallbladder, uterus, hepatocellular carcinoma, as well as olfactory neuroblastoma), the median overall survival and 2-year overall survival rates were 37.5 months and 55.9%, respectively (P=0.0001). Grade 1-2 fatigue, nausea, and vomiting were the most common adverse events, and no grade 3 and higher adverse events were observed. With excellent local control in the absence of severe toxicity, SBRT provides an alternative for patients with 1-4 liver metastases who cannot undergo surgery or other treatments.

No MeSH data available.


Related in: MedlinePlus

Analysis of initial planning CT and PET/CT as well as follow-up MRI images for a representative patient (a 23-year-old woman treated for a solitary LM from breast carcinoma).Notes: SBRT was delivered in three fractions of 14 Gy to the 81% isodose line. (A) Initial planning CT and PET/CT images showing a 3.2 cm lesion. (B–G) T1-weighted and T2-weighted MRI images showing a complete response, with decreased attenuation in the surrounding region 6 months after completion of SBRT. The red arrows indicate changes in the liver metastasis after treatment.Abbreviations: CT, computer tomography; PET/CT, positron emission tomography/computer tomography; MRI, magnetic resonance imaging; LM, liver metastasis; Gy, Gray; PTV, planning target volume; SBRT, stereotactic body radiation therapy.
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f2-ott-7-915: Analysis of initial planning CT and PET/CT as well as follow-up MRI images for a representative patient (a 23-year-old woman treated for a solitary LM from breast carcinoma).Notes: SBRT was delivered in three fractions of 14 Gy to the 81% isodose line. (A) Initial planning CT and PET/CT images showing a 3.2 cm lesion. (B–G) T1-weighted and T2-weighted MRI images showing a complete response, with decreased attenuation in the surrounding region 6 months after completion of SBRT. The red arrows indicate changes in the liver metastasis after treatment.Abbreviations: CT, computer tomography; PET/CT, positron emission tomography/computer tomography; MRI, magnetic resonance imaging; LM, liver metastasis; Gy, Gray; PTV, planning target volume; SBRT, stereotactic body radiation therapy.

Mentions: The patients were observed at 1 month after completion of treatment, every 3 months for the first year, and every 6 months thereafter until July 2012 (Figure 2). Imaging, including CT, PET/CT, magnetic resonance imaging, adverse events, and compliance were monitored in all patients for the follow-up period using our clinical databases. The primary endpoint was local control rate, and the secondary endpoints were overall survival, progression-free survival, distant progression-free survival, and adverse events. Local control was defined as complete response and partial response, and local tumor response was defined using the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria.25 In addition, local control of liver metastases was assessed at a minimum of 6 months of follow-up after SBRT in order to avoid the uncertainty associated with early transient radiographic changes in the high-dose region. Progression-free survival was defined as the time between the date of SBRT and the date of disease progression or the date of the last follow-up for censored patients. Overall survival was defined as the time between the date of the pathological diagnosis of primaries and the date of death or date of last follow-up for censored patients. Toxicity was determined according to Common Terminology Criteria for Adverse Events version 4.0.26


Stereotactic body radiation therapy using the CyberKnife(®) system for patients with liver metastases.

Yuan ZY, Meng MB, Liu CL, Wang HH, Jiang C, Song YC, Zhuang HQ, Yang D, Wang JS, Wei W, Li FT, Zhao LJ, Wang P - Onco Targets Ther (2014)

Analysis of initial planning CT and PET/CT as well as follow-up MRI images for a representative patient (a 23-year-old woman treated for a solitary LM from breast carcinoma).Notes: SBRT was delivered in three fractions of 14 Gy to the 81% isodose line. (A) Initial planning CT and PET/CT images showing a 3.2 cm lesion. (B–G) T1-weighted and T2-weighted MRI images showing a complete response, with decreased attenuation in the surrounding region 6 months after completion of SBRT. The red arrows indicate changes in the liver metastasis after treatment.Abbreviations: CT, computer tomography; PET/CT, positron emission tomography/computer tomography; MRI, magnetic resonance imaging; LM, liver metastasis; Gy, Gray; PTV, planning target volume; SBRT, stereotactic body radiation therapy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061159&req=5

f2-ott-7-915: Analysis of initial planning CT and PET/CT as well as follow-up MRI images for a representative patient (a 23-year-old woman treated for a solitary LM from breast carcinoma).Notes: SBRT was delivered in three fractions of 14 Gy to the 81% isodose line. (A) Initial planning CT and PET/CT images showing a 3.2 cm lesion. (B–G) T1-weighted and T2-weighted MRI images showing a complete response, with decreased attenuation in the surrounding region 6 months after completion of SBRT. The red arrows indicate changes in the liver metastasis after treatment.Abbreviations: CT, computer tomography; PET/CT, positron emission tomography/computer tomography; MRI, magnetic resonance imaging; LM, liver metastasis; Gy, Gray; PTV, planning target volume; SBRT, stereotactic body radiation therapy.
Mentions: The patients were observed at 1 month after completion of treatment, every 3 months for the first year, and every 6 months thereafter until July 2012 (Figure 2). Imaging, including CT, PET/CT, magnetic resonance imaging, adverse events, and compliance were monitored in all patients for the follow-up period using our clinical databases. The primary endpoint was local control rate, and the secondary endpoints were overall survival, progression-free survival, distant progression-free survival, and adverse events. Local control was defined as complete response and partial response, and local tumor response was defined using the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria.25 In addition, local control of liver metastases was assessed at a minimum of 6 months of follow-up after SBRT in order to avoid the uncertainty associated with early transient radiographic changes in the high-dose region. Progression-free survival was defined as the time between the date of SBRT and the date of disease progression or the date of the last follow-up for censored patients. Overall survival was defined as the time between the date of the pathological diagnosis of primaries and the date of death or date of last follow-up for censored patients. Toxicity was determined according to Common Terminology Criteria for Adverse Events version 4.0.26

Bottom Line: Secondary endpoints were overall survival, progression-free survival, distant progression-free survival, and adverse events.The 2-year overall survival rate was 72.2% in the favorable group (primary tumors originating from the colon, breast, or stomach, as well as sarcomas); however, in the unfavorable group (primary tumors originating from the pancreas, lung, ovary, gallbladder, uterus, hepatocellular carcinoma, as well as olfactory neuroblastoma), the median overall survival and 2-year overall survival rates were 37.5 months and 55.9%, respectively (P=0.0001).Grade 1-2 fatigue, nausea, and vomiting were the most common adverse events, and no grade 3 and higher adverse events were observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, CyberKnife Center, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin, People's Republic of China.

ABSTRACT
The aim of this study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) in the treatment of patients with liver metastases. Between August 2006 and July 2011, patients with 1-4 liver metastases were enrolled and treated with SBRT using the CyberKnife(®) system at Tianjin Medical University Cancer Institute and Hospital. The metastases were from different primary tumors, with a maximum tumor diameter of less than 6 cm. The primary endpoint was local control. Secondary endpoints were overall survival, progression-free survival, distant progression-free survival, and adverse events. Fifty-seven patients with 80 lesions were treated with SBRT. The 1-year and 2-year local control rates were 94.4% and 89.7%, respectively. The difference in local control between patients who received adjuvant treatment before SBRT and those who did not reached statistical significance (P=0.049). The median overall survival for the entire cohort was 37.5 months. According to the primary tumor sites, the median overall survival was not reached. The 2-year overall survival rate was 72.2% in the favorable group (primary tumors originating from the colon, breast, or stomach, as well as sarcomas); however, in the unfavorable group (primary tumors originating from the pancreas, lung, ovary, gallbladder, uterus, hepatocellular carcinoma, as well as olfactory neuroblastoma), the median overall survival and 2-year overall survival rates were 37.5 months and 55.9%, respectively (P=0.0001). Grade 1-2 fatigue, nausea, and vomiting were the most common adverse events, and no grade 3 and higher adverse events were observed. With excellent local control in the absence of severe toxicity, SBRT provides an alternative for patients with 1-4 liver metastases who cannot undergo surgery or other treatments.

No MeSH data available.


Related in: MedlinePlus