Berber Betul, Ibarra Rafael, Snyder Laura, Yao Min, Fabien Jeffrey, Milano Michael T, Katz Alan W, Goodman Karyn, Stephans Kevin, El-Gazzaz Galal, Aucejo Federico, Miller Charles, Fung John, Lo Simon, Machtay Mitchell, Sanabria Juan
Department of Surgery, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Department of Radiation Oncology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
HPB (Oxford). 2013 Nov;15(11):851-7. doi: 10.1111/hpb.12044. Epub 2013 Jan 14.
Surgical resection is the standard treatment for liver metastases, although for the majority of patients this is not possible. Stereotactic body radiotherapy (SBRT) is an alternative local-regional therapy. The purpose of this study was to evaluate the results of SBRT for secondary liver tumours from a combined multicentre database.
Variables from patients treated with SBRT from four Academic Medical Centres were entered into a common database. Local tumour control and 1-year survival rates were calculated.
In total, 153 patients (91 women) 59 ± 8.4 years old with 363 metastatic liver lesions were treated with SBRT. The underlying primary tumour arose from gastrointestinal (GI), retroperitoneal and from extra-abdominal primaries in 56%, 8% and 36% of patients, respectively. Metastases, with a gross tumour volume (GTV) of 138.5 ± 126.8 cm(3) , were treated with a total radiation dose of 37.5 ± 8.2 Gy in 5 ± 3 fractions. The 1-year overall survival was 51% with an overall local control rate of 62% at a mean follow-up of 25.2 ± 5.9 months. A complete tumour response was observed in 32% of patients. Grade 3-5 adverse events were noted in 3% of patients.
Secondary liver tumours treated with SBRT had a high rate of local control with a low incidence of adverse events.
手术切除是肝转移瘤的标准治疗方法，不过对大多数患者而言这并不可行。立体定向体部放疗（SBRT）是一种替代性的局部区域治疗方法。本研究的目的是通过一个联合多中心数据库评估SBRT治疗继发性肝肿瘤的结果。
来自四个学术医学中心接受SBRT治疗的患者的变量被录入一个公共数据库。计算局部肿瘤控制率和1年生存率。
总共153例患者（91名女性），年龄59±8.4岁，有363个肝转移病灶接受了SBRT治疗。原发肿瘤分别起源于胃肠道（GI）、腹膜后和腹外原发灶的患者比例分别为56%、8%和36%。转移瘤的大体肿瘤体积（GTV）为138.5±126.8 cm³，分5±3次给予总辐射剂量37.5±8.2 Gy进行治疗。1年总生存率为51%，平均随访25.2±5.9个月时总体局部控制率为62%。32%的患者观察到肿瘤完全缓解。3%的患者出现3 - 5级不良事件。
接受SBRT治疗的继发性肝肿瘤局部控制率高，不良事件发生率低。
