A Phase I Dose-Escalation Trial of Single-Fraction Stereotactic Radiation Therapy for Liver Metastases

Jeffrey J. Meyer, Ryan D. Foster, Naama Lev-Cohain, Takeshi Yokoo, Ying Dong, Roderich E. Schwarz, William Rule, Jing Tian, Yang Xie, Raquibul Hannan, Lucien Nedzi, Timothy Solberg, Robert Timmerman

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Abstract

Background: There is significant interest in the use of stereotactic ablative radiotherapy (SABR) as a treatment modality for liver metastases. A variety of SABR fractionation schemes are in clinical use. We conducted a phase I dose-escalation study to determine the maximum tolerated dose of single-fraction liver SABR. Methods: Patients with liver metastases from solid tumors, for whom a critical volume dose constraint could be met, were treated with single-fraction SABR. Seven patients were enrolled to the first group, with a prescription dose of 35 Gy. Dose was then escalated to 40 Gy in a single fraction, and seven more patients were treated at this dose level. Patients were followed for toxicity and underwent serial imaging to assess lesion response and local control. Results: Fourteen patients with 17 liver metastases were treated. There were no dose-limiting toxicities observed at either dose level. Nine of the 13 lesions assessable for treatment response showed a complete radiographic response to treatment; the remainder showed partial response. Local control of irradiated lesions was 100 % at a median imaging follow-up of 2.5 years. Two-year overall survival for all patients was 78 %. Conclusions: For selected patients with liver metastases, single-fraction SABR at doses of 35 and 40 Gy is tolerable and shows promising signs of efficacy at intermediate follow-up.

Original languageEnglish (US)
JournalAnnals of Surgical Oncology
DOIs
StateAccepted/In press - May 12 2015

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Radiotherapy
Neoplasm Metastasis
Liver
Maximum Tolerated Dose
Prescriptions
Therapeutics
Survival
Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

A Phase I Dose-Escalation Trial of Single-Fraction Stereotactic Radiation Therapy for Liver Metastases. / Meyer, Jeffrey J.; Foster, Ryan D.; Lev-Cohain, Naama; Yokoo, Takeshi; Dong, Ying; Schwarz, Roderich E.; Rule, William; Tian, Jing; Xie, Yang; Hannan, Raquibul; Nedzi, Lucien; Solberg, Timothy; Timmerman, Robert.

In: Annals of Surgical Oncology, 12.05.2015.

Research output: Contribution to journalArticle

Meyer, Jeffrey J. ; Foster, Ryan D. ; Lev-Cohain, Naama ; Yokoo, Takeshi ; Dong, Ying ; Schwarz, Roderich E. ; Rule, William ; Tian, Jing ; Xie, Yang ; Hannan, Raquibul ; Nedzi, Lucien ; Solberg, Timothy ; Timmerman, Robert. / A Phase I Dose-Escalation Trial of Single-Fraction Stereotactic Radiation Therapy for Liver Metastases. In: Annals of Surgical Oncology. 2015.
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AU - Meyer, Jeffrey J.

AU - Foster, Ryan D.

AU - Lev-Cohain, Naama

AU - Yokoo, Takeshi

AU - Dong, Ying

AU - Schwarz, Roderich E.

AU - Rule, William

AU - Tian, Jing

AU - Xie, Yang

AU - Hannan, Raquibul

AU - Nedzi, Lucien

AU - Solberg, Timothy

AU - Timmerman, Robert

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