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Strahlentherapie und Onkologie

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01-01-2012 | Original article

Stereotactic radiotherapy in the liver hilum

Basis for future studies

Authors: C. Zamboglou, M.-B. Meßmer, G. Becker, Prof. Dr. F. Momm

Published in: Strahlentherapie und Onkologie | Issue 1/2012

Abstract

Background

A basis for future trials with stereotactic body radiotherapy (SBRT) for tumors of the liver hilum should be established. Thus, dosage concepts, planning processes, and dose constraints as well as technical innovations are summarized in this contribution.

Methods

On the background of our own data, the current literature was reviewed. The use of SBRT in the most common tumors of the liver hilum (pancreatic cancer and Klatskin tumors) was investigated. Dose constraints were calculated in 2 Gy standard fractionation doses.

Results

A total of 8 pilot or phase I/II studies about SBRT in the liver hilum were identified. In recent years, the SBRT technique has developed very quickly from classical stereotactic body frame radiotherapy to IGRT techniques including gating and tracking systems. In the studies using classical body frame technique, patients experienced considerable toxicities (duodenal ulcer/perforation) as compared to tolerable side effects in IGRT studies (<10% grade 3 and 4 toxicities). Dose constraints for duodenum, liver, kidneys, colon, and spinal cord were derived from the investigated studies. Survival and local tumor control data are very heterogeneous: median survival in these patients with locally advanced pancreatic or Klatskin tumors ranges between 5 and 32 months. Excellent local tumor control rates of about 80% over 24 months were achieved using SBRT.

Conclusion

Despite a few negative results, SBRT seems to be a promising technique in the treatment of tumors of the liver hilum. Highest precision in diagnostics, positioning, and irradiation as well as strict dose constraints should be applied to keep target volumes as small as possible and side effects tolerable.

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Title: Stereotactic radiotherapy in the liver hilum
Basis for future studies
Authors: C. Zamboglou
M.-B. Meßmer
G. Becker
Prof. Dr. F. Momm
Publication date: 01-01-2012
Publisher: Urban and Vogel
Published in: Strahlentherapie und Onkologie / Issue 1/2012
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-011-0002-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Stereotactic radiotherapy in the liver hilum

Basis for future studies

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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