title: Long-term safety and efficacy of stereotactic body radiation therapy for hepatic oligometastases.
abstract: OBJECTIVE
  To evaluate long-term outcome and toxicity of stereotactic body radiation therapy (SBRT) for hepatic oligometastases from solid tumors.
  
  
  METHODS
  Eligible patients had 1 to 3 liver metastases, maximum sum diameter 6 cm, without extrahepatic progression. We treated 106 lesions in 81 patients; 67% with colorectal primaries. Median dose was 5400 cGy in 3 to 5 fractions.
  
  
  RESULTS
  At median follow-up of 33 months (2.5-70 months), overall local control was 94% (95% confidence interval, not estimable); Kaplan-Meier estimated 96% at 1 year and 91% at 2, 3, and 4 years. Partial/complete response was observed in 69% of lesions with less than 3% progressing. Median survival time was 33.6 months (95% confidence interval, 29.1-38.4); Kaplan-Meier survival estimates at 1, 2, 3, and 4 years were 89.9%, 68.6%, 44.0%, and 28.0%, respectively. Grade 3 or greater liver toxicity was 4.9%.
  
  
  CONCLUSIONS
  SBRT is effective for selected patients with hepatic oligometastases with limited toxicities. A phase 3 trial comparing SBRT with "gold-standard" surgical resection is warranted.
authors.affiliation: Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: bengoodman2010@gmail.com.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Goodman
authors.affiliation: Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Mannina
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Sandra K
authors.initials: SK
authors.lastname: Althouse
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Maluccio
authors.affiliation: Schneck Cancer Center, Seymour, Indiana.
authors.forename: Higinia R
authors.initials: HR
authors.lastname: Cárdenes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome