Review Article

Stereotactic Ablative Radiotherapy for Oligometastatic Disease in Liver

Table 1

Results of retrospective trials of SABR for liver metastases.

StudyPatients LesionsTumor volume or size (median)Type of metsDoseMedian FU LCOSToxicity

Blomgren et al. (1995) [14]14173–260 mLCRC (11)
Anal canal (1)
Kidney (1)
Ovarian (1)
7.7–45 Gy
(1–4 fx)
9.6 moNR-50% response rateNR2 cases of
hemorrhagic
gastritis

Wulf et al. (2006) [15]44 (39 liver
mets)
519–355 mLCRC (23)
Breast (11)
Ovarian (4)
Other (13)
30–37.5 Gy (3 fx)
26 Gy (1 fx)
2 yr1-yr LC, 92%,
2-yr LC, 66%
1-yr OS, 72%
2-yr OS, 32%
No grade 2–4
toxicity

Katz et al. (2007) [16]691740.6–12.5 cm
(2.7 cm)
CRC (20)
Breast (16)
Pancreas (9)
Lung (5)
Other (19)
30–55 Gy
(5–15 fx)
14.5 mo10-mo LC, 76%,
20-mo LC, 57%
Median survival,
14.5 mo,
6-mo OS, 46%,
12-mo OS, 24%
No grade 3/4
toxicity

van der Pool
et al. (2010) [17]
20310.7–6.2 cm
(2.3 cm)
All CRC30–37.5 Gy
(3 fx)
26 mo1-yr LC, 100%,
2-yr LC, 74%
Median survival,
34 mo,
1-yr OS, 100%,
2-yr OS, 83%
2 grade 3 late
liver enzyme
changes,
1 grade 2 rib
fracture

Chang et al. (2011) [18]651020.6–3088 mL
(30.1 mL)
All CRC22–60 Gy
(1–6 fx)
14.4 mo1-yr LC, 62%,
2-yr LC, 45%
1-yr OS, 72%,
2-yr OS, 38%
2 grade 3
gastritis,
2 grade 3 elevated liver enzymes.

Vautravers-Dewas et al. (2011) [19]42620.7–10 cm
(3.4 cm)
40 Gy (4 fx)
45 Gy (3 fx)
14.3 mo2-yr LC, 86%2-yr OS, 48%

Lanciano et al. (2012) [20]30 (23 liver mets)412.29–316 mL
(60.9 mL)
CRC (15)
Breast (3)
Esophagus (1)
GIST (1)
Pancreas (1)
NSCLC (2)
36–60 Gy (3 fx)
50 Gy (5 fx)
22 mo1-yr LC, 92%,
2-yr LC, 56%
1-yr OS, 73%,
2-yr OS, 31%
No grade 3/4
toxicity

Habermehl et al. (2013) [21]9013811–333 mL
(62 mL)
CRC (70)
Breast (27)
Pancreas (11)
Ovarian (7)
Lung (6)
Others (16),
by site
10–30 Gy (1 fx)21.7 mo87%, 69%, and 59% after 6, 12,
and 18 mo
Median OS 24.3 mo; local PFS was 87%, 70%, and 59% after 6, 12, and 18 mo, respectivelyNo RILD

SABR: stereotactic ablative radiotherapy; LC: local control; OS: overall survival; CRC: colorectal cancer; GIST: gastrointestinal stromal tumor; NSCLC: non-small cell lung cancer; NR: not reported; fx: fractions; RILD: radiation-induced liver disease.