Dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors using a gimbal-mounted linac: A multi-institutional phase II study.

Autor:	Iizuka Y; Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Japan., Hiraoka M; Department of Radiation Oncology, Japanese Red Cross Society Wakayama Medical Center, Japan., Kokubo M; Department of Radiation Oncology, Kobe City Medical Center General Hospital, Japan., Sakamoto T; Department of Radiation Oncology, Kyoto Katsura Hospital, Japan., Karasawa K; Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Japan., Murofushi K; Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Japan., Nakamura M; Division of Medical Physics, Department of Information Technology and Medical Engineering, Human Health Sciences, Kyoto University, Japan., Matsuo Y; Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Japan., Morita S; Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Japan., Inokuchi H; Department of Radiation Oncology, Japanese Red Cross Society Wakayama Medical Center, Japan., Mizowaki T; Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Japan.
Jazyk:	angličtina
Zdroj:	Clinical and translational radiation oncology [Clin Transl Radiat Oncol] 2023 Feb 10; Vol. 39, pp. 100591. Date of Electronic Publication: 2023 Feb 10 (Print Publication: 2023).
DOI:	10.1016/j.ctro.2023.100591
Abstrakt:	Background and Purpose: This prospective multicenter phase II study aimed to evaluate the safety and efficacy of dynamic tumor tracking (DTT) stereotactic body radiotherapy (SBRT) with real-time monitoring of liver tumors using a gimbal-mounted system. Materials and Methods: Patients with < 4 primary or metastatic liver tumors with diameters ≤ 50 mm and expected to have a respiratory motion of ≥ 10 mm were eligible. The prescribed dose was 40 Gy in five fractions. The primary endpoint was local control (LC) at 2 years. The secondary endpoints were overall survival (OS), progression-free survival (PFS), treatment-related toxicity, and tracking accuracy. Results: Between September 2015 and March 2019, 48 patients (48 lesions) with a median age of 74 years were enrolled from four institutions. Of these, 39 were diagnosed with hepatocellular carcinoma and nine with metastatic liver cancer. The median tumor diameter was 17.5 mm. DTT-SBRT was successfully performed in all patients; the median treatment time was 28 min/fraction. The median follow-up period was 36.5 months. The 2-year LC, OS, and PFS rates were 98.0 %, 88.8 %, and 55.1 %, respectively. Disease progression was observed in 33 (68.8 %) patients. One patient (0.2 %) had local recurrence, 31 (64.6 %) developed new hepatic lesions outside the irradiation field, and nine (18.8 %) had distant metastases (including overlap). Grade 3 late adverse events were observed in seven patients (14.5 %). No grade 4 or 5 treatment-related toxicity was observed. The median tracking accuracy was 2.9 mm. Conclusion: Employing DTT-SBRT to treat liver tumors results in excellent LC with acceptable adverse-event incidence. Competing Interests: Masaki Kokubo is in a speaker’s bureau from AstraZeneca K.K.; Takashi Sakamoto is in a speaker’s bureau from SCETI.K.K.; Mitsuhiro Nakamura receives research funding from Varian Medical Systems, Inc. and a scholarship donation from Hitachi, Ltd.; Yukinori Matsuo receives research funding from Varian Medical Systems, Inc.; Takashi Mizowaki has received honoraria from Varian Medical Systems, Inc., Elekta K.K., Hitachi, Ltd., and Brainlab AG; played a consulting or advisory role for Varian Medical Systems, Inc. Hitachi, Ltd.; has research funding from Hitachi, Ltd. and educational projects from Varian Medical Systems and Brainlab AG. Other authors have no conflicts of interest to declare. (© 2023 The Author(s).)
Databáze:	MEDLINE
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