Dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors using a gimbal-mounted linac: A multi-institutional phase II study
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 pri...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630823000162 |
| _version_ | 1811162780312535040 |
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| author | Yusuke Iizuka Masahiro Hiraoka Masaki Kokubo Takashi Sakamoto Katsuyuki Karasawa Keiko Murofushi Mitsuhiro Nakamura Yukinori Matsuo Satoshi Morita Haruo Inokuchi Takashi Mizowaki |
| author_facet | Yusuke Iizuka Masahiro Hiraoka Masaki Kokubo Takashi Sakamoto Katsuyuki Karasawa Keiko Murofushi Mitsuhiro Nakamura Yukinori Matsuo Satoshi Morita Haruo Inokuchi Takashi Mizowaki |
| author_sort | Yusuke Iizuka |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-10T06:34:40Z |
| format | Article |
| id | doaj.art-f85d233fe9c84469887a84dfd334732a |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-04-10T06:34:40Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-f85d233fe9c84469887a84dfd334732a2023-03-01T04:32:23ZengElsevierClinical and Translational Radiation Oncology2405-63082023-03-0139100591Dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors using a gimbal-mounted linac: A multi-institutional phase II studyYusuke Iizuka0Masahiro Hiraoka1Masaki Kokubo2Takashi Sakamoto3Katsuyuki Karasawa4Keiko Murofushi5Mitsuhiro Nakamura6Yukinori Matsuo7Satoshi Morita8Haruo Inokuchi9Takashi Mizowaki10Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Japan; Corresponding author at: 54 Shogoin-Kawaharacho, Sakyo, Kyoto 6068507, Japan.Department of Radiation Oncology, Japanese Red Cross Society Wakayama Medical Center, JapanDepartment of Radiation Oncology, Kobe City Medical Center General Hospital, JapanDepartment of Radiation Oncology, Kyoto Katsura Hospital, JapanDivision of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, JapanDivision of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, JapanDivision of Medical Physics, Department of Information Technology and Medical Engineering, Human Health Sciences, Kyoto University, JapanDepartment of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, JapanDepartment of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, JapanDepartment of Radiation Oncology, Japanese Red Cross Society Wakayama Medical Center, JapanDepartment of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, JapanBackground 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.http://www.sciencedirect.com/science/article/pii/S2405630823000162LiverMalignant neoplasmsMetastasisStereotactic body radiotherapyDynamic tumor tracking |
| spellingShingle | Yusuke Iizuka Masahiro Hiraoka Masaki Kokubo Takashi Sakamoto Katsuyuki Karasawa Keiko Murofushi Mitsuhiro Nakamura Yukinori Matsuo Satoshi Morita Haruo Inokuchi Takashi Mizowaki Dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors using a gimbal-mounted linac: A multi-institutional phase II study Clinical and Translational Radiation Oncology Liver Malignant neoplasms Metastasis Stereotactic body radiotherapy Dynamic tumor tracking |
| title | Dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors using a gimbal-mounted linac: A multi-institutional phase II study |
| title_full | Dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors using a gimbal-mounted linac: A multi-institutional phase II study |
| title_fullStr | Dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors using a gimbal-mounted linac: A multi-institutional phase II study |
| title_full_unstemmed | Dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors using a gimbal-mounted linac: A multi-institutional phase II study |
| title_short | Dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors using a gimbal-mounted linac: A multi-institutional phase II study |
| title_sort | dynamic tumor tracking stereotactic body radiotherapy with real time monitoring of liver tumors using a gimbal mounted linac a multi institutional phase ii study |
| topic | Liver Malignant neoplasms Metastasis Stereotactic body radiotherapy Dynamic tumor tracking |
| url | http://www.sciencedirect.com/science/article/pii/S2405630823000162 |
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