title: Multicenter results of stereotactic body radiotherapy (SBRT) for non-resectable primary liver tumors.
abstract: BACKGROUND
  An excess of 100 000 individuals are diagnosed with primary liver tumors every year in USA but less than 20% of those patients are amenable to definitive surgical management due to advanced local disease or comorbidities. Local therapies to arrest tumor growth have limited response and have shown no improvement on patient survival. Stereotactic body radiotherapy (SBRT) has emerged as an alternative local ablative therapy. The purpose of this study was to evaluate the tumor response to SBRT in a combined multicenter database.
  
  
  METHODS
  Patients with advanced hepatocellular carcinoma (HCC, n = 21) or intrahepatic cholangiocarcinoma (ICC, n = 11) treated with SBRT from four Academic Medical Centers were entered into a common database. Statistical analyses were performed for freedom from local progression (FFLP) and patient survival.
  
  
  RESULTS
  The overall FFLP for advanced HCC was 63% at a median follow-up of 12.9 months. Median tumor volume decreased from 334.2 to 135 cm(3) (p < 0.004). The median time to local progression was 6.3 months. The 1- and 2-years overall survival rates were 87% and 55%, respectively. Patients with ICC had an overall FFLP of 55.5% at a median follow-up of 7.8 months. The median time to local progression was 4.2 months and the six-month and one-year overall survival rates were 75% and 45%, respectively. The incidence of grade 1-2 toxicities, mostly nausea and fatigue, was 39.5%. Grade 3 and 4 toxicities were present in two and one patients, respectively.
  
  
  CONCLUSIONS
  Higher rates of FFLP were achieved by SBRT in the treatment of primary liver malignancies with low toxicity.
authors.affiliation: Department of Surgery, University Hospitals-Case Medical Center, 11100 Euclid Ave., Cleveland, OH 44106, USA.
authors.forename: Rafael A
authors.initials: RA
authors.lastname: Ibarra
authors.forename: Daniel
authors.initials: D
authors.lastname: Rojas
authors.forename: Laura
authors.initials: L
authors.lastname: Snyder
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fabien
authors.forename: Michael
authors.initials: M
authors.lastname: Milano
authors.forename: Alan
authors.initials: A
authors.lastname: Katz
authors.forename: Karyn
authors.initials: K
authors.lastname: Goodman
authors.forename: Kevin
authors.initials: K
authors.lastname: Stephans
authors.forename: Galal
authors.initials: G
authors.lastname: El-Gazzaz
authors.forename: Federico
authors.initials: F
authors.lastname: Aucejo
authors.forename: Charles
authors.initials: C
authors.lastname: Miller
authors.forename: John
authors.initials: J
authors.lastname: Fung
authors.forename: Simon
authors.initials: S
authors.lastname: Lo
authors.forename: Mitchell
authors.initials: M
authors.lastname: Machtay
authors.forename: Juan R
authors.initials: JR
authors.lastname: Sanabria
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016634:Radiosurgery; D015996:Survival Rate; D055815:Young Adult