肝脏寡转移的大型汇总分析,根据ESTRO/EORTC的建议进行分类,进行立体定向放疗(SBRT)和放射外科(SRS)治疗。在疗效和毒性方面分析了接受SBRT/SRS治疗肝转移患者的临床和剂量学数据。特别是,本地控制(LC)远处转移自由生存(DMFS),无病生存(DFS),总生存率(OS),并分析了下一次无系统治疗生存率(NEST-FS)。113名患者(M/F:49/64),评估了两个意大利放射治疗机构中总共150个肝脏病变(2006年3月至2023年2月)。中位年龄为67岁(36-92岁),48例(42.5%)患者至少有一种合并症。大多数病变是诱发的(30.7%)或重复的寡进行性转移(12.7%)。98个病灶接受了超过一个每日部分的治疗(主要是5个部分中的50Gy),而52是放射外科治疗(主要是32Gy)。在3-4个月的治疗反应可在147个病变中评估:完全反应为32.0%,部分反应17.0%,病情稳定32.0%。精算LC,DMFS,DFS,操作系统,一年的NEST-FS为75.8%,37.7%,34.9%,78.7%,和59.4%;而精算LC,DMFS,DFS,操作系统,NEST-FS在2年时为52.1%,24.9%,21.9%,51.3%,和36.8%,分别。实现完全响应,同步寡核苷酸,没有治疗中断与更有利的结果相关。根据毒性概况,我们仅记录了2例急性和1例高于2级的晚期毒性病例。就局部控制而言,立体定向治疗肝转移似乎是一种安全且有希望的选择。完全缓解的患者获得了最佳结果,同步寡核苷酸,有利的组织学,没有治疗中断。
A large pooled analysis of liver oligometastases, classified accordingly to the ESTRO/EORTC recommendations, treated by stereotactic radiotherapy (SBRT) and Radiosurgery (SRS) was carried out. The clinical and dosimetric data of patients who underwent SBRT/SRS for liver metastases were analysed in terms of efficacy and toxicity profile. In particular, the Local Control (LC), the Distant Metastases Free Survival (DMFS), the Disease-Free Survival (DFS), the Overall Survival (OS), and the Next Systemic Therapy Free Survival (NEST-FS) rates were analysed. 113 patients (M/F: 49/64), accounting for a total of 150 hepatic lesions (March 2006-February 2023) in two Italian radiotherapy Institutions were evaluated. Median age was 67 years old (36-92) and 48 (42.5%) patients had at least one comorbidity. The majority of the lesions were induced (30.7%) or repeated oligoprogressive (12.7%) metastases. 98 lesions were treated with more than one daily fraction (mainly 50 Gy in 5 fractions), while 52 were radiosurgery treatments (mainly 32 Gy). The treatment response at 3-4 months was evaluable in 147 lesions: complete response was 32.0%, partial response 17.0%, and stable disease 32.0%. Actuarial LC, DMFS, DFS, OS, and NEST-FS at 1 year were 75.8%, 37.7%, 34.9%, 78.7%, and 59.4% respectively; while actuarial LC, DMFS, DFS, OS, and NEST-FS at 2 years were 52.1%, 24.9%, 21.9%, 51.3%, and 36.8%, respectively. The achievement of complete response, synchronous oligometastases, and no treatment interruptions correlated with a more favorable outcomes. As per the toxicity profile, we registered only two acute and one late toxicity cases higher than grade 2. Stereotactic treatment for liver metastases seems to be a safe and promising option in terms of local control. The best results in term of outcomes have been obtained in patients with complete response, synchronous oligometastases, favorable histology, and no treatment interruptions.