title: Motion management during SBRT for oligometastatic cancer: Results of a prospective phase II trial.
abstract: To optimize the local control of stereotactic body radiotherapy (SBRT) using the Vero-SBRT system and respiratory motion management in patients with oligometastatic cancer.
  
  
  
  Patients with five or less metastases were eligible. In metastases with significant motion, a fiducial was implanted for Vero dynamic tracking. For other metastases an internal target volume (ITV) was defined to encompass the respiratory tumor trajectory. A dose of 50Gy in 10 fractions was prescribed on the 80% isodose line.
  
  
  
  We treated 87 metastases in 44 patients, with colorectal cancer as the most common primary origin (65.9%). Metastatic sites were mainly lung (n=62) and liver (n=17). Twenty-seven metastases were treated with dynamic tracking, the remaining 60 using the ITV-concept. Three patients (7%) experienced grade ⩾3 toxicity. After a median follow-up of 12months, the overall one-year local control (LC) amounted to 89% (95% CI 77-95%), with corresponding values of 90% and 88% for the metastases irradiated with the ITV-approach and dynamic tracking, respectively. Median progression-free survival reached 6.5months, one-year overall survival 95%.
  
  
  
  SBRT with proper respiratory motion management resulted in a high LC and an acceptable toxicity profile in oligometastatic cancer patients.
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Robbe
authors.initials: R
authors.lastname: Van den Begin
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Engels
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Marlies
authors.initials: M
authors.lastname: Boussaer
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Dhont
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Manuela
authors.initials: M
authors.lastname: Burghelea
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Tom
authors.initials: T
authors.lastname: Depuydt
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Poels
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Christine
authors.initials: C
authors.lastname: Collen
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Gevaert
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Verellen
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Storme
authors.affiliation: Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: de Mey
authors.affiliation: Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium. Electronic address: Mark.DeRidder@uzbrussel.be.
authors.forename: Mark
authors.initials: M
authors.lastname: De Ridder
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009038:Motion; D009362:Neoplasm Metastasis; D058958:Organs at Risk; D011446:Prospective Studies; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*
keywords: Motion management; Oligometastases; SBRT; Tomotherapy; Vero