PMID- 21432842
OWN - NLM
STAT- MEDLINE
DCOM- 20111013
LR  - 20220331
IS  - 1097-0142 (Electronic)
IS  - 0008-543X (Linking)
VI  - 117
IP  - 17
DP  - 2011 Sep 1
TI  - Stereotactic body radiotherapy for colorectal liver metastases: a pooled 
      analysis.
PG  - 4060-9
LID - 10.1002/cncr.25997 [doi]
AB  - BACKGROUND: This study was undertaken to determine outcomes of stereotactic body 
      radiotherapy for colorectal liver metastases in a pooled patient cohort. METHODS: 
      Patients with colorectal liver metastases from 3 institutions were included if 
      they had 1 to 4 lesions, received 1 to 6 fractions of stereotactic body 
      radiotherapy, and had radiologic imaging >/= 3 months post-treatment. Sixty-five 
      patients with 102 lesions treated from August 2003 to May 2009 were 
      retrospectively analyzed. A tumor control probability (TCP) model was used to 
      estimate the 3-fraction dose required for > 90% local control after converting 
      the schedule into biologically equivalent dose (BED), single-fraction equivalent 
      dose, or linear quadratic model-based single-fraction dose. RESULTS: Forty-seven 
      (72%) patients had >/= 1 chemotherapy regimen before stereotactic body 
      radiotherapy, and 27 (42%) patients had >/= 2 regimens. The median follow-up was 
      1.2 years (range, 0.3-5.2 years). The median dose was 42 gray (Gy; range, 22-60 
      Gy). When evaluated separately by multivariate analysis, total dose (P = .0015), 
      dose/fraction (P = .003), and BED (P = .004) all correlated with local control by 
      lesion. On multivariate analysis, nonactive extrahepatic disease was associated 
      with overall survival (OS; P = .046), and sustained local control was closely 
      correlated (P = .06). By using single-fraction equivalent dose, BED, or linear 
      quadratic model-based single-fraction dose in the TCP model, the estimated dose 
      range needed for 1-year local control > 90% is 46 to 52 Gy in 3 fractions. 
      CONCLUSIONS: Liver stereotactic body radiotherapy is well tolerated and effective 
      for colorectal liver metastases. The strong correlation between local control and 
      OS supports controlling hepatic disease even for heavily pretreated patients. For 
      a 3-fraction regimen of stereotactic body radiotherapy, a prescription dose of >/= 
      48 Gy should be considered, if normal tissue constraints allow.
CI  - Cancer 2011 (c) 2011 American Cancer Society.
FAU - Chang, Daniel T
AU  - Chang DT
AD  - Department of Radiation Oncology, Stanford University, Stanford, California, USA. 
      dtchang@stanford.edu
FAU - Swaminath, Anand
AU  - Swaminath A
FAU - Kozak, Margaret
AU  - Kozak M
FAU - Weintraub, Julie
AU  - Weintraub J
FAU - Koong, Albert C
AU  - Koong AC
FAU - Kim, John
AU  - Kim J
FAU - Dinniwell, Rob
AU  - Dinniwell R
FAU - Brierley, James
AU  - Brierley J
FAU - Kavanagh, Brian D
AU  - Kavanagh BD
FAU - Dawson, Laura A
AU  - Dawson LA
FAU - Schefter, Tracey E
AU  - Schefter TE
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20110322
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
SB  - IM
EIN - Cancer. 2012 May 15;118(10):2776
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Colorectal Neoplasms/*pathology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Liver Neoplasms/*radiotherapy/secondary
MH  - Male
MH  - Middle Aged
MH  - Radiosurgery/adverse effects/*methods
MH  - Radiotherapy Dosage
MH  - Treatment Outcome
EDAT- 2011/03/25 06:00
MHDA- 2011/10/14 06:00
CRDT- 2011/03/25 06:00
PHST- 2010/07/13 00:00 [received]
PHST- 2010/10/05 00:00 [revised]
PHST- 2010/12/28 00:00 [accepted]
PHST- 2011/03/25 06:00 [entrez]
PHST- 2011/03/25 06:00 [pubmed]
PHST- 2011/10/14 06:00 [medline]
AID - 10.1002/cncr.25997 [doi]
PST - ppublish
SO  - Cancer. 2011 Sep 1;117(17):4060-9. doi: 10.1002/cncr.25997. Epub 2011 Mar 22.