Bordeau Karl, Michalet Morgan, Keskes Aïcha, Valdenaire Simon, Debuire Pierre, Cantaloube Marie, Cabaillé Morgane, Jacot William, Draghici Roxana, Demontoy Sylvain, Quantin Xavier, Ychou Marc, Assenat Eric, Mazard Thibault, Gauthier Ludovic, Dupuy Marie, Guiu Boris, Bourgier Céline, Aillères Norbert, Fenoglietto Pascal, Azria David, Riou Olivier
Montpellier Cancer Institute (ICM), University Federation of Radiation Oncology of Mediterranean Occitanie, University Montpellier, INSERM U1194 IRCM, 34298 Montpellier, France.
Medical Oncology Department, Montpellier Cancer Institute (ICM), University Montpellier, 34298 Montpellier, France.
J Clin Med. 2023 Feb 2;12(3):1183. doi: 10.3390/jcm12031183.
Liver stereotactic body radiotherapy (SBRT) is a local treatment that provides good local control and low toxicity. We present the first clinical results from our prospective registry of stereotactic MR-guided radiotherapy (MRgRT) for liver metastases. All patients treated for liver metastases were included in this prospective registry study. Stereotactic MRgRT indication was confirmed by multidisciplinary specialized tumor boards. The primary endpoints were acute and late toxicities. The secondary endpoints were survival outcomes (local control, overall survival (OS), disease-free survival, intrahepatic relapse-free survival). Twenty-six consecutive patients were treated for thirty-one liver metastases between October 2019 and April 2022. The median prescribed dose was 50 Gy (40-60) in 5 fractions. No severe acute MRgRT-related toxicity was noted. Acute and late gastrointestinal and liver toxicities were low and mostly unrelated to MRgRT. Only 5 lesions (16.1%) required daily adaptation because of the proximity of organs at risk (OAR). With a median follow-up time of 17.3 months since MRgRT completion, the median OS, 1-year OS and 2-year OS rates were 21.7 months, 83.1% (95% CI: 55.3-94.4%) and 41.6% (95% CI: 13.5-68.1%), respectively, from MRgRT completion. The local control at 6 months, 1 year and 2 years was 90.9% (95% CI: 68.3-97.7%). To our knowledge, we report the largest series of stereotactic MRgRT for liver metastases. The treatment was well-tolerated and achieved a high LC rate. Distant relapse remains a challenge in this population.
肝脏立体定向体部放射治疗（SBRT）是一种局部治疗方法，具有良好的局部控制效果和低毒性。我们展示了来自我们前瞻性立体定向磁共振引导放射治疗（MRgRT）肝脏转移瘤登记研究的首批临床结果。所有接受肝脏转移瘤治疗的患者均纳入了这项前瞻性登记研究。立体定向MRgRT的适应症由多学科专业肿瘤委员会确认。主要终点是急性和晚期毒性。次要终点是生存结果（局部控制、总生存期（OS）、无病生存期、肝内无复发生存期）。2019年10月至2022年4月期间，连续26例患者接受了31个肝脏转移瘤的治疗。中位处方剂量为50 Gy（40 - 60），分5次给予。未观察到严重的急性MRgRT相关毒性。急性和晚期胃肠道及肝脏毒性较低，且大多与MRgRT无关。仅5个病灶（16.1%）因危及器官（OAR）临近需要每日调整。自MRgRT完成后，中位随访时间为17.3个月，从MRgRT完成起，中位OS、1年OS率和2年OS率分别为21.7个月、83.1%（95%CI：55.3 - 94.4%）和41.6%（95%CI：13.5 - 68.1%）。6个月、1年和2年时的局部控制率为90.9%（95%CI：68.3 - 97.7%）。据我们所知，我们报告了最大系列的肝脏转移瘤立体定向MRgRT治疗。该治疗耐受性良好，局部控制率高。远处复发在这一人群中仍然是一个挑战。
