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Radiosurgery of Liver Tumors: Value of Robotic Radiosurgical Device to Treat Liver Tumors

  • Radiation Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The treatment of isolated liver metastases has become a rapidly developing field with many new, technically advanced methods. Here we present the therapeutic efficacy of a robotic radiosurgery for local control of liver metastases from solid tumors.

Methods

Patients with tumorous lesions to the liver, not qualifying for surgery, were treated with single-session radiosurgery (24 Gy) that used robotic image-guided real-time tumor tracking. All detectable lesions had to be irradiated. In a prospective analysis, follow-up was performed by magnetic resonance imaging scanning 2 months after the treatment, and subsequently at 3-month intervals to evaluate local control. For inclusion into the radiosurgery treatment protocol, tumor volumes had to be <90 ml.

Results

Thirty-six patients (median age, 65 years) with a total of 54 target lesions were evaluated. Single lesions were treated in 23 patients and multiple targets in 13 patients. Metastases originated from colon cancer (n = 19), ovarian cancer (n = 3), pancreatic cancer (n = 2), breast cancer (n = 2), and others (n = 6). Four lesions were of primary liver origin (hepatocellular carcinoma and cholangiocellular carcinoma). Median tumor volume was 18 ml (range, 2.2–90 ml). The median follow-up was 21.3 months. The disease of 25 patients (69.4%) showed complete or partial local response, 6 patients (16.7%) had stable lesions, and 5 patients (14%) experienced local recurrence. Grade 2–4 adverse events due to radiation treatment were not observed.

Conclusions

Robotic radiosurgery with image-guided real-time tumor tracking of liver neoplasm is a new and promising approach for patients with disease that is not eligible for surgical resection and might enhance the possibilities of multidisciplinary oncological treatment concepts.

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Conflict of Interest Statement

The authors state that they have no conflicts of interest with Accuray Inc.

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Authors and Affiliations

  1. Department of Hematology and Oncology, University Hospital Grosshadern, LMU Munich, Munich, Germany

    Sebastian Stintzing MD & Volker Heinemann MD, PhD

  2. Institute of Clinical Radiology, University Hospital Grosshadern, LMU Munich, Munich, Germany

    Ralf-Thorsten Hoffmann MD, PhD

  3. European CyberKnife Center Munich, Munich, Germany

    Markus Kufeld MD & Alexander Muacevic MD, PhD

  4. Department of Surgery, University Hospital Grosshadern, LMU Munich, Munich, Germany

    Markus Rentsch MD, PhD

Authors
  1. Sebastian Stintzing MD
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  2. Ralf-Thorsten Hoffmann MD, PhD
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  3. Volker Heinemann MD, PhD
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  4. Markus Kufeld MD
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  5. Markus Rentsch MD, PhD
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  6. Alexander Muacevic MD, PhD
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Correspondence to Sebastian Stintzing MD.

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Stintzing, S., Hoffmann, RT., Heinemann, V. et al. Radiosurgery of Liver Tumors: Value of Robotic Radiosurgical Device to Treat Liver Tumors. Ann Surg Oncol 17, 2877–2883 (2010). https://doi.org/10.1245/s10434-010-1187-9

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  • DOI: https://doi.org/10.1245/s10434-010-1187-9

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