Stereotactic body radiotherapy (SBRT) for primary liver tumors


Status:

Patient recruitment closed
project finished

Study PI:

Prof. Dr. med. Thomas Brunner
University Hospital Magdeburg
thomas.brunner@med.ovgu.de

Study design:

● multi-center, international retrospective study

Study objective:

●To perform a patterns-of-care and patterns-of-outcome analysis of SBRT for primary liver tumors in Germany, Austria and Switzerland
● To evaluate patient and treatment factor influencing outcome in SBRT for primary liver tumors

Project status:

● Data collection completed
● 1 manuscript submitted, 1 manuscript in preparation
● Further analyses planned and possible

Major findings and results:

Bettinger D, Pinato DJ, Schultheiss M, et al (2019) Stereotactic Body Radiation Therapy as an Alternative Treatment for Patients with Hepatocellular Carcinoma Compared to Sorafenib: A Propensity Score Analysis. Liver Cancer 8:281–294.
www.pubmed.ncbi.nlm.nih.gov/31602371/

  • International retrospective matched pair analysis of patients with advanced hepatocellular carcinoma treated with SBRT or sorafenib
  • 122 patients treated with SBRT and 901 patients treated with sorafenib were compared for overall survival and progression-free survival
  • Baseline characteristics between groups were adjusted by propensity score matching
  • Median overall survival in adjusted, matched analysis:
    16.0 months SBRT group vs. 9.6 months sorafenib group (HR 0.53, p=0.005)
  • Progression-free survival in adjusted, matched analysis:
    9.0 months SBRT group vs. 6.0 months sorafenib group (HR 0.59, p=0.004)

Brunner TB, Blanck O, Lewitzki V, et al (2019) Stereotactic body radiotherapy dose and its impact on local control and overall survival of patients for locally advanced intrahepatic and extrahepatic cholangiocarcinoma. Radiotherapy and Oncology 132:42–47.
www.pubmed.ncbi.nlm.nih.gov/30825968/

  • 64 patients with 82 non-resectable primary lesions of cholangiocarcinomas treated with SBRT were analyzed retrospectively for overall survival, local control, and toxicity
  • Median follow-up 35 months, median OS 15 months, 2-y-OS 32%, 3-y-OS 21%
  • Stat. significant prognostic factor for LC and OS in univariate analysis: biologically effective dose (BEDmax>91 Gy10)
  • BEDmax>91 Gy10: 1-y-LC 91%, 2-y-LC 80%, median OS 24 months
  • BEDmax<91 Gy10: 1-y-LC 66%, 2-y-LC 39%, median OS 13 months
  • Tumor size and PTV were neither predictive nor prognostic for LC or OS
  • Toxicity: 17% G1 gastroduodenitis, 11% G2-3 cholangitis, 4.7% G3 GI-bleeding

Gkika E, Tanadini-Lang S, Kirste S. Interobserver variability in the target delineation of hepatocellular carcinoma: An analysis of the working group on Stereotactic Radiotherapy of the German Society for Radiation Oncology (DEGRO). 
www.ncbi.nlm.nih.gov/pubmed/28695316

  • The analysis was performed within the working group on Stereotactic Radiotherapy of the German Society for Radiation Oncology (DEGRO).
  • Sixteen physicians (12 radiation oncologists, 2 liver surgeons, 1 radiologist and 1 nuclear medicine physician) delineated the gross tumor volume (GTV) of three anonymized HCC cases.
  • The intra observer variability was very good among the cases were the tumor was well defined.
  • Yet, in complex cases were the tumor did not show the typical characteristics or in cases with lipiodol deposits IOA agreement was compromised.