Amendola Beatriz, Amendola Marco, Blanco Jesús M, Perez Naipy, Wu Xiaodong
Innovative Cancer Institute, South Miami, FL 33143, United States.
Rep Pract Oncol Radiother. 2017 Mar-Apr;22(2):118-125. doi: 10.1016/j.rpor.2016.10.001. Epub 2016 Dec 21.
To report our initial results on the use of radiosurgery for treatment of liver metastases.
In recent years there has been increasing interest in the use of stereotactic body radiation therapy to treat metastatic disease to the liver as an alternative to interventional procedures.
Between November 2008 and June 2015 a total of 36 LINAC-based radiosurgeries using VMAT were performed in 27 patients with liver metastases from 10 different primary sites. Doses ranged from 21 Gy to 60 Gy in 1 to 5 fractions. In all patients the volume of liver receiving less than 15 Gy was more than 700 cc. The volume treated with the prescription dose ranged from 1 cc to 407 cc with a median of 58 cc. All patients but one received systemic treatment.
Overall median survival for the entire group is 9 months (ranging from 1 to 67 months). Local recurrence free survival ranged from 4 to 67 months with a median of 14 months. Twenty patients (80%) survived more than six months. Three patients treated for oligometastases were alive after 3 years. Grade 0 toxicity was encountered in 22/27 patients, Grade 1 toxicity in 5/27 and only 1/27 patient experienced Grade 2 toxicity. No patient experienced grade 3-4 toxicity.
Based on these initial results we conclude that SBRT for treating liver metastases with radiosurgery is safe and effective for treating one or multiple lesions as long as normal tissue constraints for liver are respected.
报告我们使用放射外科治疗肝转移瘤的初步结果。
近年来，作为介入治疗的替代方法，立体定向体部放射治疗用于治疗肝转移瘤越来越受到关注。
2008年11月至2015年6月期间，对27例来自10个不同原发部位的肝转移瘤患者共进行了36次基于直线加速器的容积调强弧形治疗放射外科手术。剂量在21 Gy至60 Gy之间，分1至5次给予。所有患者中，接受小于15 Gy辐射的肝脏体积均超过700 cc。接受处方剂量治疗的体积范围为1 cc至407 cc，中位数为58 cc。除1例患者外，所有患者均接受了全身治疗。
整个组的总体中位生存期为9个月（范围为1至67个月）。局部无复发生存期为4至67个月，中位数为14个月。20例患者（80%）存活超过6个月。3例接受寡转移瘤治疗的患者在3年后仍存活。22/27例患者出现0级毒性，5/27例出现1级毒性，仅1/27例患者出现2级毒性。无患者出现3 - 4级毒性。
基于这些初步结果，我们得出结论，只要尊重肝脏正常组织的限制，使用放射外科进行立体定向体部放射治疗肝转移瘤对于治疗一个或多个病灶是安全有效的。
