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Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
Published on: May 8, 2018
Helical tomotherapy for simultaneous multitarget radiotherapy for pulmonary metastasis
Ji Yoon Kim1, Chul Seung Kay, Yeon Sil Kim
1Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Summary
Tomotherapy offers a safe and effective treatment for select patients with lung metastases, achieving a 12-month survival rate of 60.5%. Further prospective trials are recommended to confirm these findings on pulmonary metastases treatment.
Area of Science:
- Radiation Oncology
- Medical Physics
- Clinical Oncology
Background:
- Pulmonary metastases represent a significant challenge in cancer management.
- Tomotherapy offers advanced capabilities for precise radiation delivery.
Purpose of the Study:
- To evaluate the safety and efficacy of tomotherapy for simultaneous multitarget radiotherapy in patients with pulmonary metastases.
- To identify prognostic factors influencing survival outcomes.
Main Methods:
- Retrospective analysis of 31 patients treated with tomotherapy for pulmonary metastases.
- Definition of gross tumor volume (GTV) and planning target volume (PTV) with margins.
- Prescribed doses of 50 Gy to GTV and 40 Gy to PTV in 10 fractions over 2 weeks.
- Online image-guided corrections and registration for precise treatment delivery.
- Kaplan-Meier method and log rank test for survival analysis.
Main Results:
- Overall survival rate at 12 months was 60.5%, with a median survival time of 16.0 months.
- Favorable prognostic factors included ECOG performance status ≤1, breast/colon primary cancer, complete primary lesion control, and response at 3 months.
- Progression-free survival rates at 1 and 2 years were 39.6% and 27.7%, respectively.
- Posttreatment failure rate was 64.5%, with regional failure being most common (51.6%).
- Grades I and II radiation toxicity observed in 41.9% and 16.0% of patients, respectively; no treatment-related deaths.
Conclusions:
- Tomotherapy is a potentially safe and effective treatment option for select patients with lung metastases.
- Further large-scale, prospective clinical trials are warranted to validate these findings.
- Tomotherapy facilitates precise delivery for complex radiotherapy cases like pulmonary metastases.
