Radiosurgery for liver metastases. A single institution experience.

AIM: To report our initial results on the use of radiosurgery for treatment of liver metastases.

BACKGROUND: In recent years there has been increasing interest in the use of stereotactic body radiation therapy to treat metastatic disease to the liver as an alternative to interventional procedures.

MATERIALS AND METHODS: Between November 2008 and June 2015 a total of 36 LINAC-based radiosurgeries using VMAT were performed in 27 patients with liver metastases from 10 different primary sites. Doses ranged from 21 Gy to 60 Gy in 1 to 5 fractions. In all patients the volume of liver receiving less than 15 Gy was more than 700 cc. The volume treated with the prescription dose ranged from 1 cc to 407 cc with a median of 58 cc. All patients but one received systemic treatment.

RESULTS: Overall median survival for the entire group is 9 months (ranging from 1 to 67 months). Local recurrence free survival ranged from 4 to 67 months with a median of 14 months. Twenty patients (80%) survived more than six months. Three patients treated for oligometastases were alive after 3 years. Grade 0 toxicity was encountered in 22/27 patients, Grade 1 toxicity in 5/27 and only 1/27 patient experienced Grade 2 toxicity. No patient experienced grade 3-4 toxicity.

CONCLUSION: Based on these initial results we conclude that SBRT for treating liver metastases with radiosurgery is safe and effective for treating one or multiple lesions as long as normal tissue constraints for liver are respected.