caa a22 4500 445335823 CHVBK 20180317142754.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1245/s10434-010-1405-5 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1405-5 Phase I Dose-Escalation Study of Stereotactic Body Radiotherapy in Patients With Hepatic Metastases [Elektronische Daten] [William Rule, Robert Timmerman, Liyue Tong, Ramzi Abdulrahman, Jeffrey Meyer, Thomas Boike, Roderich Schwarz, Paul Weatherall, L. Chinsoo Cho] Purpose: To identify a tolerable and effective dose for 5-fraction stereotactic body radiotherapy for hepatic metastases. Methods: Patients were enrolled onto three dose-escalation cohorts: 30Gy in 3 fractions, 50Gy in 5 fractions, and 60Gy in 5 fractions. Eligible patients had one to five hepatic metastases, ability to spare a critical hepatic volume (volume receiving <21Gy) of 700ml, adequate baseline hepatic function, no concurrent antineoplastic therapy, and a Karnofsky performance score of ≥60. Dose-limiting toxicity included treatment-related grade 3 toxicity in the gastrointestinal, hepatobiliary/pancreas, and metabolic/laboratory categories. Any grade 4 or 5 event attributable to therapy was defined as a dose-limiting toxicity. Local control (LC) and complete plus partial response rates were assessed. Results: Twenty-seven patients, 9 in each cohort, with 37 lesions were enrolled and treated: 17 men and 11 women; median age 62 (range 48-86) years; most common site of primary disease, colorectal (44.4%). Median follow-up was 20 (range 4-53) months. There was no grade 4 or 5 toxicity or treatment-related grade 3 toxicity. Actuarial 24-month LC rates for the 30-, 50-, and 60-Gy cohorts were 56%, 89%, and 100%, respectively. There was a statistically significant difference for LC between the 60- and 30-Gy cohorts (P=0.009) but not between the 60- and 50-Gy cohorts (P=0.56) or the 50- and 30-Gy cohorts (P=0.091). The maximum tolerated dose was not reached. Conclusions: A dose of 60Gy in 5 fractions can be safely delivered to selected patients with hepatic metastases as long as the critical liver volume is respected. A dose of 60Gy in 5 fractions yields an excellent level of LC. Society of Surgical Oncology, 2010 Rule William Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Road, Dallas, TX, USA aut Timmerman Robert Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Road, Dallas, TX, USA aut Tong Liyue Division of Biostatistics, University of Texas Southwestern, Dallas, TX, USA aut Abdulrahman Ramzi Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Road, Dallas, TX, USA aut Meyer Jeffrey Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Road, Dallas, TX, USA aut Boike Thomas Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Road, Dallas, TX, USA aut Schwarz Roderich Department of Surgical Oncology, University of Texas Southwestern, Dallas, TX, USA aut Weatherall Paul Department of Radiology, University of Texas Southwestern, Dallas, TX, USA aut Chinsoo Cho L. Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA aut Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 1081-1087 1068-9265 18:4<1081 2011 18 10434 https://doi.org/10.1245/s10434-010-1405-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1405-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Rule William Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Road, Dallas, TX, USA aut NATIONALLICENCE 700 1- Timmerman Robert Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Road, Dallas, TX, USA aut NATIONALLICENCE 700 1- Tong Liyue Division of Biostatistics, University of Texas Southwestern, Dallas, TX, USA aut NATIONALLICENCE 700 1- Abdulrahman Ramzi Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Road, Dallas, TX, USA aut NATIONALLICENCE 700 1- Meyer Jeffrey Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Road, Dallas, TX, USA aut NATIONALLICENCE 700 1- Boike Thomas Department of Radiation Oncology, University of Texas Southwestern, 5801 Forest Park Road, Dallas, TX, USA aut NATIONALLICENCE 700 1- Schwarz Roderich Department of Surgical Oncology, University of Texas Southwestern, Dallas, TX, USA aut NATIONALLICENCE 700 1- Weatherall Paul Department of Radiology, University of Texas Southwestern, Dallas, TX, USA aut NATIONALLICENCE 700 1- Chinsoo Cho L. Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 1081-1087 1068-9265 18:4<1081 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer