Single Shot Liver: MR-guided stereotactic body radiotherapy (SBRT) for hepatic malignancies and metastasis

Background: In the treatment of inoperable hepatic malignancies and metastases, the importance of SBRT has increased significantly in recent years. Up to now, multi-day concepts (often 3-5 fractions) have been the standard therapy. In the prospective Single Shot Liver study, MR-guided single-shot radiotherapy is being investigated with regard to feasibility, toxicity and local control.

Methods: Patients with 1-3 hepatic metastases or malignancies<5 cm receive MR-guided irradiation with 1 x 28 Gy dosed to the PTV (80% isodose). The primary objective is to record 1-year local control, toxicity, laboratory chemical changes and extrahepatic tumour control. From 09/2021 to 07/2024, 36 patients have been included: this analysis includes the data of the first 26 patients who have reached the 1-year follow-up (31 irradiated fractions, 34 lesions).

Results: Acute side effects associated with radiotherapy occurred up to a maximum of CTC°1-2 (most common fatigue, nausea, diarrhea). 6 patients died before the end of the 1-year follow-up (not RT-associated). One patient showed a recurrence after one year (primary colon carcinoma), one metastasis was resected after 6 months due to rest vitality (primary NET pancreas). All other lesions (94%) are controlled up to the available follow-up.

Conclusion: MR-guided single-dose irradiation is a safe and effective therapy for hepatic metastases and primary tumours (1-year local control rate 94%). There have been no major side effects to date. In the future, multi-day concepts can be shortened in favour of single-dose irradiation if feasible in terms of dosimetry of organs at risk.

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Artikel online veröffentlicht:
20. Januar 2025