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SHR Neuro Cancer Cardio Lipid Metab Microb

Gkika, E; Strouthos, I; Kirste, S; Adebahr, S; Schultheiss, M; Bettinger, D; Fritsch, R; Brass, V; Maruschke, L; Neeff, HP; Lang, SA; Nestle, U; Grosu, AL; Brunner, TB.
Repeated SBRT for in- and out-of-field recurrences in the liver.
Strahlenther Onkol. 2019; 195(3):246-253 Doi: 10.1007/s00066-018-1385-0
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Co-authors Med Uni Graz: Brunner Thomas Baptist
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Abstract:: PURPOSE: To evaluate the feasibility and toxicity profile of repeated stereotactic body radiotherapy (SBRT) for recurrent primary or secondary liver tumors. METHODS: Consecutive patients with primary (hepatocellular carcinoma [HCC] or cholangiocarcinoma [CCC]) or secondary liver cancer (LM), with intrahepatic recurrence or progression after SBRT, underwent re-SBRT in 3 to 12 fractions with a median time of 15 (range 2-66) months between treatments. RESULTS: In all, 24 patients which were previously treated with SBRT (30 lesions) were retreated with SBRT for "in- and out-of-field" recurrences (2nd SBRT: n = 28, 3rd SBRT: n = 2). The median follow-up after re-irradiation was 14 months. The median prescribed dose for the first SBRT was 46.5 (range 33-66 Gy, EQD2₁₀ = 70.5) Gy and 48 (range 27-66 Gy, EQD2₁₀ = 71) Gy for the re-SBRT. The median mean liver dose (D_{mean, liver}) was 6 Gy (range 1-25, EQD2₂ = 7 Gy) for the first SBRT and 10 Gy (range 1-63 Gy, EQD2₂ = 9 Gy) for the re-SBRT. Of the 30 re-irradiated lesions 6 were re-irradiated in-field resulting in a median EQD2_{2, maximum} of 359 (range 120-500) Gy for both treatments, with an α/β = 2 to account for liver parenchyma. Treatment was well tolerated. Two patients with stent placement before SBRT developed cholangitis 4 and 14 months after re-SBRT. There were no elevations of the serum liver parameters after re-SBRT. One patient developed a grade 3 gastrointestinal bleeding. There was no radiation induced liver disease (RILD) observed. CONCLUSIONS: Repeated liver SBRT is feasible, without excessive liver toxicity, when there is no considerable overlapping with pre-irradiated portions of the stomach or bowel and enough time for the liver to regenerate.
Find related publications in this database (using NLM MeSH Indexing): Adult - administration & dosage; Aged - administration & dosage; Aged, 80 and over - administration & dosage; Bile Duct Neoplasms - radiotherapy; Carcinoma, Hepatocellular - radiotherapy; Cholangiocarcinoma - radiotherapy; Dose Fractionation, Radiation - administration & dosage; Female - administration & dosage; Follow-Up Studies - administration & dosage; Germany - administration & dosage; Humans - administration & dosage; Liver Neoplasms - radiotherapy, secondary; Male - administration & dosage; Middle Aged - administration & dosage; Neoplasm Recurrence, Local - radiotherapy; Radiosurgery - methods; Retreatment - administration & dosage
Find related publications in this database (Keywords): Re-SBRT; Hepatocellular carcinoma; Cholangiocarcinoma; Liver metastases; Stereotactic body radiotherapy