Scoring system predictive of survival for patients undergoing stereotactic body radiation therapy for liver tumors

Radiation Oncology

Keith Unger¹  Gregory Gagnon¹  Anatoly Dritschilo¹  Sean P Collins¹  Brian T Collins¹  Marie-Adele S Kress¹ 

[1] Department of Radiation Oncolog, Georgetown University Hospital, Lower Level Bles, 3800 Reservoir Road, Georgetown, N.W. Washington, D.C., 20007, USA

关键词: CyberKnife;    Stereotactic body radiation therapy;    Liver tumors;    Hepatic metastases;    Liver metastases;    Liver;   

Others  :  1155362
DOI  :  10.1186/1748-717X-7-148

 received in 2012-06-07, accepted in 2012-08-25,  发布年份 2012

【 摘 要 】

Background

Stereotactic body radiation therapy (SBRT) is an emerging treatment option for liver tumors. This study evaluated outcomes after SBRT to identify prognostic variables and to develop a novel scoring system predictive of survival.

Methods

The medical records of 52 patients with a total of 85 liver lesions treated with SBRT from 2003 to 2010 were retrospectively reviewed. Twenty-four patients had 1 lesion; 27 had 2 or more. Thirteen lesions were primary tumors; 72 were metastases. Fiducials were placed in all patients prior to SBRT. The median prescribed dose was 30 Gy (range, 16 – 50 Gy) in a median of 3 fractions (range, 1–5).

Results

With median follow-up of 11.3 months, median overall survival (OS) was 12.5 months, and 1 year OS was 50.8%. In 42 patients with radiographic follow up, 1 year local control was 74.8%. On univariate analysis, number of lesions (p = 0.0243) and active extralesional disease (p < 0.0001) were predictive of OS; Karnofsky Performance Status (KPS) approached statistical significance (p = 0.0606). A scoring system for predicting survival was developed by allocating 1 point for each of the three following factors: active extralesional disease, 2 or more lesions, and KPS ≤ 80%. Score was associated with OS (p < 0.0001). For scores of 0, 1, 2 and 3, median survival intervals were 34, 12.5, 7.6, and 2.8 months, respectively.

Conclusions

SBRT offers a safe and feasible treatment option for liver tumors. A prognostic scoring system based on the number of liver lesions, activity of extralesional disease, and KPS predicts survival following SBRT and can be used as a guide for prospective validation and ultimately for treatment decision-making.

【 授权许可】

   
2012 Kress et al.; licensee BioMed Central Ltd.

【 图 表 】

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