Skip to main content
SpringerLink
Log in

Hypofractionated radiotherapy with Tomotherapy for patients with hepatic oligometastases: retrospective analysis of two institutions

  • Research Paper
  • Published:
Clinical & Experimental Metastasis Aims and scope Submit manuscript

Abstract

To evaluate the efficacy and toxicity for patients with hepatic oligometastases, receiving hypofractionated radiotherapy with Tomotherapy to the liver. A total of 42 patients with 54 hepatic lesions, who had been treated from 2007 to 2011 at two institutions, were retrospectively reviewed for this study. All the patients received radical resections of the primary tumor, and had been presented with one to two hepatic lesions. The radiation dose of 40–75 Gy in 10–20 fractions (median, 50 Gy in 10 fractions) was delivered for the planning target volume. At a median follow-up time of 15 months, 1- and 2-year local control (LC) rates were 59.9 and 49.0 %, respectively. The 1- and 2-year overall survival (OS) rates were 60.0 and 44.0 %, respectively. Maximal tumor diameter of <3 cm and biologically effective dose (BED) of ≥100 Gyα/β=10 were significantly associated with higher LC and OS. Primary colorectal cancer tended to be associated with higher LC (P = 0.075), and was significantly associated with higher OS (P = 0.037). 12 (28.6 %) of the 42 patients had grade 1–2 toxicities, and grade 3 or higher toxicity did not occur. Hypofractionated radiotherapy with Tomotherapy was safe for patients with hepatic oligometastases. The maximal tumor diameter of <3 cm and BED of ≥100 Gyα/β=10 were significant prognostic factors for higher local control and survival, and primary colorectal cancer patients had statistically higher overall survival than the others.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

RFA:

Radiofrequency thermal ablation

IMRT:

Intensity-modulated radiation therapy

BED:

Biologically effective dose

PTV:

Planning target volume

GTV:

Gross tumor volume

References

  1. Niibe Y, Hayakawa K (2010) Oligometastases and oligo-recurrence: the new era of cancer therapy. Jpn J Clin Oncol 40(2):107–111

    Article  PubMed  Google Scholar 

  2. Buscarini E, Savoia A, Brambilla G et al (2005) Radiofrequency thermal ablation of liver tumors. Eur Radiol 15(5):884–894

    Article  PubMed  Google Scholar 

  3. Shibata T, Niinobu T, Ogata N et al (2000) Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma. Cancer 89(2):276–284

    Article  PubMed  CAS  Google Scholar 

  4. Topkan E, Onal HC, Yavuz MN (2008) Managing liver metastases with conformal radiation therapy. J Support Oncol 6(1):9–13

    PubMed  Google Scholar 

  5. Kang JK, Kim MS, Kim JH et al (2010) Oligometastases confined one organ from colorectal cancer treated by SBRT. Clin Exp Metastasis 27(4):273–278

    Article  PubMed  Google Scholar 

  6. Rusthoven KE, Kavanagh BD, Cardenes H et al (2009) Multiinstitutional phase I/II trial of stereotactic body radiation therapy for liver metastases. J Clin Oncol 27(10):1572–1578

    Article  PubMed  Google Scholar 

  7. Heron DE, Gerszten K, Selvaraj RN et al (2003) Conventional 3D conformal versus intensity-modulated radiotherapy for the adjuvant treatment of gynecologic malignancies: a comparative dosimetric study of dose–volume histograms small star, filled. Gynecol Oncol 91(1):39–45

    Article  PubMed  CAS  Google Scholar 

  8. Wulf J, Guckenberger M, Haedinger U et al (2006) Stereotactic radiotherapy of primary liver cancer and hepatic metastases. Acta Oncol 45(7):838–847

    Article  PubMed  Google Scholar 

  9. Decoster L, Schallier D, Everaert H et al (2008) Complete metabolic tumour response, assessed by 18-fluorodeoxyglucose positron emission tomography (18FDG-PET), after induction chemotherapy predicts a favourable outcome in patients with locally advanced non-small cell lung cancer (NSCLC). Lung Cancer 62(1):55–61

    Article  PubMed  CAS  Google Scholar 

  10. Hellman S, Weichselbaum RR (1995) Oligometastases. J Clin Oncol 13(1):8–10

    PubMed  CAS  Google Scholar 

  11. McCammon R, Schefter TE, Gaspar LE et al (2009) Observation of a dose–control relationship for lung and liver tumors after stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys 73(1):112–118

    Article  PubMed  Google Scholar 

  12. Onishi H, Araki T, Shirato H et al (2004) Stereotactic hypofractionated high-dose irradiation for stage I nonsmall cell lung carcinoma: clinical outcomes in 245 subjects in a Japanese multiinstitutional study. Cancer 101(7):1623–1631

    Article  PubMed  Google Scholar 

  13. Lee JH, Kim SH, Kim JG et al (2011) Preoperative Chemoradiotherapy (CRT) followed by laparoscopic surgery for rectal cancer: predictors of the tumor response and the long-term oncologic outcomes. Int J Radiat Oncol Biol Phys 81(2):431–438

    Article  PubMed  Google Scholar 

  14. Jung KW, Park S, Kong HJ et al (2011) Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2009. Cancer Res Treat 44(1):11–24

    Article  Google Scholar 

  15. Lee JH, Jang HS, Kim JG et al (2012) Lymphovascular invasion is a significant prognosticator in rectal cancer patients who receive preoperative chemoradiotherapy followed by total mesorectal excision. Ann Surg Oncol 19(4):1213–1221

    Article  PubMed  Google Scholar 

  16. Lee JH, Kim DY, Nam TK et al (2012) Long-term follow-up of preoperative pelvic radiation therapy and concomitant boost irradiation in locally advanced rectal cancer patients: a multi-institutional phase II study (KROG 04-01). Int J Radiat Oncol Biol Phys 84(4):955–961

    Article  PubMed  Google Scholar 

  17. Aloia TA, Vauthey JN, Loyer EM et al (2006) Solitary colorectal liver metastasis: resection determines outcome. Arch Surg 141(5):460–466

    Article  PubMed  Google Scholar 

  18. Nordlinger B, Guiguet M, Vaillant JC et al (1996) Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer 77(7):1254–1262

    Article  PubMed  CAS  Google Scholar 

  19. Scheele J, Stangl R, Altendorf-Hofmann A et al (1991) Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 110(1):13–29

    PubMed  CAS  Google Scholar 

  20. De Leyn P, Stroobants S, De Wever W et al (2006) Prospective comparative study of integrated positron emission tomography-computed tomography scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage IIIA-N2 non-small-cell lung cancer: a Leuven lung cancer group study. J Clin Oncol 24(21):3333–3339

    Article  PubMed  Google Scholar 

  21. Lubezky N, Metser U, Geva R et al (2007) The role and limitations of 18-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) scan and computerized tomography (CT) in restaging patients with hepatic colorectal metastases following neoadjuvant chemotherapy: comparison with operative and pathological findings. J Gastrointest Surg 11(4):472–478

    Article  PubMed  Google Scholar 

  22. Van den Eynden GG, Bird NC, Majeed AW et al (2012) The histological growth pattern of colorectal cancer liver metastases has prognostic value. Clin Exp Metastasis 29(6):541–549

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (0820010). We thank Eun Joong Kim, nurse (St. Vincent’s Hospital, The Catholic University of Korea, Suwon, South Korea) for data collection.

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, 93-6, Ji-dong, Paldal-gu, Suwon, Gyeonggi-do, 442-723, Republic of Korea

    Jong Hoon Lee, Hyo Chun Lee, Jung Won Lee, Dae Gyu Kang & Sung Hwan Kim

  2. Department of Radiation Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Joo Hwan Lee & Hong Seok Jang

  3. Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea

    Byoung Yong Shim

  4. Department of Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea

    Bong-Hyeon Kye, Hyung Jin Kim, Hyeon-Min Cho & Young Jin Suh

Authors
  1. Jong Hoon Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joo Hwan Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hong Seok Jang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hyo Chun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jung Won Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dae Gyu Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Byoung Yong Shim
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Bong-Hyeon Kye
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hyung Jin Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hyeon-Min Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Young Jin Suh
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Sung Hwan Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sung Hwan Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, J.H., Lee, J.H., Jang, H.S. et al. Hypofractionated radiotherapy with Tomotherapy for patients with hepatic oligometastases: retrospective analysis of two institutions. Clin Exp Metastasis 30, 643–650 (2013). https://doi.org/10.1007/s10585-013-9568-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10585-013-9568-7

Keywords

Search

Navigation