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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2016

Open Access 01-01-2016 | Hepatobiliary Tumors

A Phase I Dose-Escalation Trial of Single-Fraction Stereotactic Radiation Therapy for Liver Metastases

Authors: Jeffrey J. Meyer, MD, Ryan D. Foster, PhD, Naama Lev-Cohain, MD, Takeshi Yokoo, MD, PhD, Ying Dong, MD, PhD, Roderich E. Schwarz, MD, PhD, William Rule, MD, Jing Tian, PhD, Yang Xie, PhD, Raquibul Hannan, MD, PhD, Lucien Nedzi, MD, Timothy Solberg, PhD, Robert Timmerman, MD

Published in: Annals of Surgical Oncology | Issue 1/2016

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Abstract

Background

There is significant interest in the use of stereotactic ablative radiotherapy (SABR) as a treatment modality for liver metastases. A variety of SABR fractionation schemes are in clinical use. We conducted a phase I dose-escalation study to determine the maximum tolerated dose of single-fraction liver SABR.

Methods

Patients with liver metastases from solid tumors, for whom a critical volume dose constraint could be met, were treated with single-fraction SABR. Seven patients were enrolled to the first group, with a prescription dose of 35 Gy. Dose was then escalated to 40 Gy in a single fraction, and seven more patients were treated at this dose level. Patients were followed for toxicity and underwent serial imaging to assess lesion response and local control.

Results

Fourteen patients with 17 liver metastases were treated. There were no dose-limiting toxicities observed at either dose level. Nine of the 13 lesions assessable for treatment response showed a complete radiographic response to treatment; the remainder showed partial response. Local control of irradiated lesions was 100 % at a median imaging follow-up of 2.5 years. Two-year overall survival for all patients was 78 %.

Conclusions

For selected patients with liver metastases, single-fraction SABR at doses of 35 and 40 Gy is tolerable and shows promising signs of efficacy at intermediate follow-up.
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Metadata
Title
A Phase I Dose-Escalation Trial of Single-Fraction Stereotactic Radiation Therapy for Liver Metastases
Authors
Jeffrey J. Meyer, MD
Ryan D. Foster, PhD
Naama Lev-Cohain, MD
Takeshi Yokoo, MD, PhD
Ying Dong, MD, PhD
Roderich E. Schwarz, MD, PhD
William Rule, MD
Jing Tian, PhD
Yang Xie, PhD
Raquibul Hannan, MD, PhD
Lucien Nedzi, MD
Timothy Solberg, PhD
Robert Timmerman, MD
Publication date
01-01-2016
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 1/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4579-z

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