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

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

Research output: Contribution to journalArticle

38 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)218-224
Number of pages7
JournalAnnals of surgical oncology
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Meyer, J. J., Foster, R. D., Lev-Cohain, N., Yokoo, T., Dong, Y., Schwarz, R. E., Rule, W., Tian, J., Xie, Y., Hannan, R., Nedzi, L., Solberg, T., & Timmerman, R. (2016). A Phase I Dose-Escalation Trial of Single-Fraction Stereotactic Radiation Therapy for Liver Metastases. Annals of surgical oncology, 23(1), 218-224. https://doi.org/10.1245/s10434-015-4579-z