title: Dosimetric comparison of brachyablation and stereotactic ablative body radiotherapy in the treatment of liver metastasis.
abstract: OBJECTIVE
  We compared the dosimetry of brachyablation (BA) and stereotactic ablative radiotherapy (SABR) in the treatment of liver metastases.
  
  
  METHODS
  Treatment plans for 10 consecutive liver metastasis patients, treated with SABR, were replanned for BA. BA treatment was planned using five 12 Gy fractions to the same planning target volume (PTV) used for SABR. Dosimetric parameters were compared using a Student's paired t test.
  
  
  CONCLUSIONS
  BA and SABR plans had similar mean volume receiving 100% of the prescribed dose (94.1% vs. 93.9% of PTV, p = 0.8). Mean volume receiving 150% of the prescribed dose for BA was 63.6%, whereas for SABR it was 0. The minimum dose to the PTV was 65.8% for BA, whereas for SABR it was 87.4% (p = 0.0002). Liver volume receiving ≥15 Gy was similar for BA and SABR (278 vs. 256 cc, p = 0.3). Small bowel mean dose, as percent prescription dose, was higher for BA (10.8% vs. 7.1%, p = 0.006). Stomach mean dose was similar (4.9% vs. 4.8% of prescription dose, p = 0.98). Right kidney mean dose was greater for BA (6.7% vs. 4.2%, p = 0.07). BA leads to a higher target dose, similar dose to organs at risk, but potentially with lower target coverage compared with SABR. Further work is needed to determine ideal suitability for mono vs. combination therapy with this approach.
authors.affiliation: Department of Radiation Oncology, UCLA Medical Center, Los Angeles, CA.
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Pennington
authors.affiliation: Department of Radiation Oncology, UCLA Medical Center, Los Angeles, CA.
authors.forename: Sang June
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, UCLA Medical Center, Los Angeles, CA.
authors.forename: Narine
authors.initials: N
authors.lastname: Abgaryan
authors.affiliation: Department of Radiation Oncology, UCLA Medical Center, Los Angeles, CA.
authors.forename: Robyn
authors.initials: R
authors.lastname: Banerjee
authors.affiliation: Department of Radiation Oncology, UCLA Medical Center, Los Angeles, CA.
authors.forename: Percy P
authors.initials: PP
authors.lastname: Lee
authors.affiliation: Department of Interventional Radiology, UCLA Medical Center, Los Angeles, CA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Loh
authors.affiliation: Department of Interventional Radiology, UCLA Medical Center, Los Angeles, CA.
authors.forename: Edward
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, UCLA Medical Center, Los Angeles, CA.
authors.forename: D Jeffrey
authors.initials: DJ
authors.lastname: Demanes
authors.affiliation: Department of Radiation Oncology, UCLA Medical Center, Los Angeles, CA. Electronic address: MKamrava@mednet.ucla.edu.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Kamrava
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000528:radiation effects; D007668:Kidney / Q000528:radiation effects; D008099:Liver / Q000528:radiation effects; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D058958:Organs at Risk / Q000528:radiation effects*; D011832:Radiation Injuries / Q000517:prevention & control*; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted; D013270:Stomach / Q000528:radiation effects
keywords: Brachyablation; Image guided brachytherapy; Liver metastasis; SABR; Stereotactic body radiotherapy