title: Stereotactic body radiation therapy for primary and metastatic liver tumors.
abstract: OBJECTIVE
  The full potential of stereotactic body radiation therapy (SBRT), in the treatment of unresectable intrahepatic malignancies, has yet to be realized as our experience is still limited. Thus, we evaluated SBRT outcomes for primary and metastatic liver tumors, with the goal of identifying factors that may aid in optimization of therapy.
  
  
  METHODS
  From 2005 to 2010, 62 patients with 106 primary and metastatic liver tumors were treated with SBRT to a median biologic effective dose (BED) of 100 Gy (42.6-180). The majority of patients received either three (47%) or five fractions (48%). Median gross tumor volume (GTV) was 8.8 cm(3) (0.2-222.4).
  
  
  RESULTS
  With a median follow-up of 18 months (0.46-46.8), freedom from local progression (FFLP) was observed in 97 of 106 treated tumors, with 1- and 2-year FFLP rates of 93% and 82%. Median overall survival (OS) for all patients was 25.2 months, with 1- and 2-year OS of 81% and 52%. Neither BED nor GTV significantly predicted for FFLP. Local failure was associated with a higher risk of death [hazard ratio (HR) = 5.1, P = .0007]. One Child-Pugh Class B patient developed radiation-induced liver disease. There were no other significant toxicities.
  
  
  CONCLUSIONS
  SBRT provides excellent local control for both primary and metastatic liver lesions with minimal toxicity. Future studies should focus on appropriate selection of patients and on careful assessment of liver function to maximize both the safety and efficacy of treatment.
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, MI.
authors.forename: Erqi
authors.initials: E
authors.lastname: Liu
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Stenmark
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Schipper
authors.forename: James M
authors.initials: JM
authors.lastname: Balter
authors.forename: Marc L
authors.initials: ML
authors.lastname: Kessler
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Caoili
authors.forename: Oliver E
authors.initials: OE
authors.lastname: Lee
authors.forename: Edgar
authors.initials: E
authors.lastname: Ben-Josef
authors.forename: Theodore S
authors.initials: TS
authors.lastname: Lawrence
authors.forename: Mary
authors.initials: M
authors.lastname: Feng
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