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Background <p>Despite advancements in liver tumor treatments, a persistent need remains for minimally invasive therapies with high efficacy and long-term outcomes. In a previous multicenter phase II study, the safety and efficacy of dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors were evaluated using a gimbal-mounted system. Herein, we report the updated long-term results of this technique.</p> Methods <p>This observational study examined patients with a single liver tumor, respiratory movement of at least 10&#xa0;mm, performance status of 0–2, and Child–Pugh score of &lt; 9. Patients who agreed to participate in the trial underwent dynamic tumor-tracking stereotactic body radiotherapy (prescribed dose, 40&#xa0;Gy in five fractions for the planning target volume [D<sub>95</sub>]; 70% of the maximum dose). The primary endpoint was the 4-year overall survival rate. Secondary endpoints included 4-year local control and progression-free survival rates and the incidence of adverse events.</p> Results <p>Between September 2015 and March 2019, 48 patients (median age, 74&#xa0;years; median tumor diameter, 17.5 mm) underwent dynamic tumor-tracking stereotactic body radiotherapy. All lesions were successfully treated (hepatocellular carcinoma, 39 patients; liver metastases, 9 patients). The median observation period was 46&#xa0;months, and the 4-year overall survival, local control, and progression-free survival rates were 67.4%, 97.9%, and 29.1%, respectively. Eight patients had grade 3 hepatobiliary enzyme elevation, hematologic toxicity, or hyponatremia; none had grade ≥ 4 adverse events.</p> Conclusion <p>These findings demonstrate&#xa0;the long-term safety and efficacy of dynamic tumor-tracking stereotactic body radiotherapy for liver tumors,&#xa0;with&#xa0;an&#xa0;excellent&#xa0;local control rate.</p>

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Long-term results of dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring using a gimbal-mounted linac for liver tumors: a multicenter observational study

  • 期刊论文

  • 发表日期：

    2025年3月21日

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  • Yusuke Iizuka,
  • Minoru Inoue,
  • Masaki Kokubo,
  • Takashi Sakamoto,
  • Keiko Nemoto Murofushi,
  • Toshiyuki Imagumbai,
  • Takuya Shimizuguchi,
  • Masahiro Hiraoka,
  • Takashi Mizowaki

摘要

Background

Despite advancements in liver tumor treatments, a persistent need remains for minimally invasive therapies with high efficacy and long-term outcomes. In a previous multicenter phase II study, the safety and efficacy of dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors were evaluated using a gimbal-mounted system. Herein, we report the updated long-term results of this technique.

Methods

This observational study examined patients with a single liver tumor, respiratory movement of at least 10 mm, performance status of 0–2, and Child–Pugh score of < 9. Patients who agreed to participate in the trial underwent dynamic tumor-tracking stereotactic body radiotherapy (prescribed dose, 40 Gy in five fractions for the planning target volume [D95]; 70% of the maximum dose). The primary endpoint was the 4-year overall survival rate. Secondary endpoints included 4-year local control and progression-free survival rates and the incidence of adverse events.

Results

Between September 2015 and March 2019, 48 patients (median age, 74 years; median tumor diameter, 17.5 mm) underwent dynamic tumor-tracking stereotactic body radiotherapy. All lesions were successfully treated (hepatocellular carcinoma, 39 patients; liver metastases, 9 patients). The median observation period was 46 months, and the 4-year overall survival, local control, and progression-free survival rates were 67.4%, 97.9%, and 29.1%, respectively. Eight patients had grade 3 hepatobiliary enzyme elevation, hematologic toxicity, or hyponatremia; none had grade ≥ 4 adverse events.

Conclusion

These findings demonstrate the long-term safety and efficacy of dynamic tumor-tracking stereotactic body radiotherapy for liver tumors, with an excellent local control rate.