Andratschke, N., Alheid, H., Allgaeuer, M., Becker, G., Blanck, O., Boda-Heggemann, J., Brunner, T., Duma, M., Gerum, S., Guckenberger, M., Hildebrandt, G., Klement, R. J., Lewitzki, V., Ostheimer, C., Papachristofilou, A., Petersen, C., Schneider, T., Semrau, R., Wachter, S. and Habermehl, D. (2018). The SBRT database initiative of the German Society for Radiation Oncology (DEGRO): patterns of care and outcome analysis of stereotactic body radiotherapy (SBRT) for liver oligometastases in 474 patients with 623 metastases. BMC Cancer, 18. LONDON: BIOMED CENTRAL LTD. ISSN 1471-2407

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Abstract

Background: The intent of this pooled analysis as part of the German society for radiation oncology (DEGRO) stereotactic body radiotherapy (SBRT) initiative was to analyze the patterns of care of SBRT for liver oligometastases and to derive factors influencing treated metastases control and overall survival in a large patient cohort. Methods: From 17 German and Swiss centers, data on all patients treated for liver oligometastases with SBRT since its introduction in 1997 has been collected and entered into a centralized database. In addition to patient and tumor characteristics, data on immobilization, image guidance and motion management as well as dose prescription and fractionation has been gathered. Besides dose response and survival statistics, time trends of the aforementioned variables have been investigated. Results: In total, 474 patients with 623 liver oligometastases (median 1 lesion/patient; range 1-4) have been collected from 1997 until 2015. Predominant histologies were colorectal cancer (n = 213 pts.; 300 lesions) and breast cancer (n = 57; 81 lesions). All centers employed an SBRT specific setup. Initially, stereotactic coordinates and CT simulation were used for treatment set-up (55%), but eventually were replaced by CBCT guidance (28%) or more recently robotic tracking (17%). High variance in fraction (fx) number (median 1 fx; range 1-13) and dose per fraction (median: 18.5 Gy; range 3-37.5 Gy) was observed, although median BED remained consistently high after an initial learning curve. Median follow-up time was 15 months; median overall survival after SBRT was 24 months. One-and 2-year treated metastases control rate of treated lesions was 77% and 64%; if maximum isocenter biological equivalent dose (BED) was greater than 150 Gy EQD2Gy, it increased to 83% and 70%, respectively. Besides radiation dose colorectal and breast histology and motion management methods were associated with improved treated metastases control. Conclusion: After an initial learning curve with regards to total cumulative doses, consistently high biologically effective doses have been employed translating into high local tumor control at 1 and 2 years. The true impact of histology and motion management method on treated metastases control deserve deeper analysis. Overall survival is mainly influenced by histology and metastatic tumor burden.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Andratschke, N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alheid, H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Allgaeuer, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Becker, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blanck, O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boda-Heggemann, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brunner, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Duma, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerum, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guckenberger, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hildebrandt, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klement, R. J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lewitzki, V.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ostheimer, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Papachristofilou, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petersen, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schneider, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Semrau, R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wachter, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Habermehl, D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-192782
DOI: 10.1186/s12885-018-4191-2
Journal or Publication Title: BMC Cancer
Volume: 18
Date: 2018
Publisher: BIOMED CENTRAL LTD
Place of Publication: LONDON
ISSN: 1471-2407
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
PHASE I/II TRIAL; HEPATIC METASTASES; THERAPY SBRT; LUNG-CANCER; TUMORSMultiple languages
OncologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/19278

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