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Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
Published on: May 8, 2018
[Stereotactic body radiation therapy for non-spine bone oligometastatic disease]
J-C Faivre1, V Marchesi1, S Thureau2
1Academic Radiation Oncology & Brachytherapy Department, Lorraine Institute of Cancerology, Alexis-Vautrin Comprehensive Cancer Center, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France.
Purpose:
Stereotaxic radiotherapy is performed regularly for the irradiation of non-spine bone metastases, but its place is not well understood.
Materials And Methods:
This article in stereotaxic radiotherapy of non-spine bones oligometastases presents the current scientific data relating to the indications, to virtual simulation, to the delineation of target volumes, to the total dose and fractionation, to the efficacy and tolerance.
Results:
Oligometastatic patients are classified into 4 categories: oligorecurrences, oligometastasis, oligopersistence, oligoprogression. The prognosis will be evaluated according to the following characteristics: primary tumor, quantitative characteristics, kinetics, qualitative characteristics. The delineation of GTV includes extensions to the soft tissue and bone marrow with the aid of MRI and PET. The CTV corresponds to a margin of 2 to 5mm and the PTV to a margin of 2mm. The most widely used irradiation schemes are: 1 single fraction of 18 to 24Gy/1 fr; 24Gy/2 fr; 27 to 30Gy/3 fr; 30 to 35Gy/5 fr. Stereotaxis provides 90% local control at 1 year and good pain control. The side effects are not very marked.
Conclusion:
Stereotaxic radiotherapy is feasible, non-invasive, minimally toxic and effective with good local control and good pain relief. The main issue remains selecting the patients most likely to benefit from it.
