TY  - JOUR
A1  - Andratschke, N.
A1  - Alheid, H.
A1  - Allgäuer, M.
A1  - Becker, G.
A1  - Blanck, O.
A1  - Boda-Heggemann, J.
A1  - Brunner, T.
A1  - Duma, M.
A1  - Gerum, S.
A1  - Guckenberger, M.
A1  - Hildebrandt, G.
A1  - Klement, R. J.
A1  - Lewitzki, V.
A1  - Ostheimer, C.
A1  - Papachristofilou, A.
A1  - Petersen, C.
A1  - Schneider, T.
A1  - Semrau, R.
A1  - Wachter, S.
A1  - Habermehl, D.
T1  - The SBRT database initiative of the German Society for Radiation Oncology (DEGRO): patterns of care and outcome analysis of stereotactic body radiotherapy (SBRT) for liver oligometastases in 474 patients with 623 metastases
JF  - BMC Cancer
N2  - Background
The intent of this pooled analysis as part of the German society for radiation oncology (DEGRO) stereotactic body radiotherapy (SBRT) initiative was to analyze the patterns of care of SBRT for liver oligometastases and to derive factors influencing treated metastases control and overall survival in a large patient cohort.

Methods
From 17 German and Swiss centers, data on all patients treated for liver oligometastases with SBRT since its introduction in 1997 has been collected and entered into a centralized database. In addition to patient and tumor characteristics, data on immobilization, image guidance and motion management as well as dose prescription and fractionation has been gathered. Besides dose response and survival statistics, time trends of the aforementioned variables have been investigated.

Results
In total, 474 patients with 623 liver oligometastases (median 1 lesion/patient; range 1–4) have been collected from 1997 until 2015. Predominant histologies were colorectal cancer (n = 213 pts.; 300 lesions) and breast cancer (n = 57; 81 lesions). All centers employed an SBRT specific setup. Initially, stereotactic coordinates and CT simulation were used for treatment set-up (55%), but eventually were replaced by CBCT guidance (28%) or more recently robotic tracking (17%). High variance in fraction (fx) number (median 1 fx; range 1–13) and dose per fraction (median: 18.5 Gy; range 3–37.5 Gy) was observed, although median BED remained consistently high after an initial learning curve. Median follow-up time was 15 months; median overall survival after SBRT was 24 months. One- and 2-year treated metastases control rate of treated lesions was 77% and 64%; if maximum isocenter biological equivalent dose (BED) was greater than 150 Gy EQD2Gy, it increased to 83% and 70%, respectively. Besides radiation dose colorectal and breast histology and motion management methods were associated with improved treated metastases control.

Conclusion
After an initial learning curve with regards to total cumulative doses, consistently high biologically effective doses have been employed translating into high local tumor control at 1 and 2 years. The true impact of histology and motion management method on treated metastases control deserve deeper analysis. Overall survival is mainly influenced by histology and metastatic tumor burden.
KW  - stereotactic body radiotherapy
KW  - liver oligometastases
KW  - outcome
KW  - treated metastases control
KW  - oligometastases
KW  - oligo-recurrence
KW  - sync-oligometastases
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-221116
VL  - 18
ER  - 
TY  - JOUR
A1  - Klement, Rainer J.
A1  - Abbasi-Senger, N.
A1  - Adebahr, S.
A1  - Alheid, H.
A1  - Allgaeuer, M.
A1  - Becker, G.
A1  - Blanck, O.
A1  - Boda-Heggemann, J.
A1  - Brunner, T.
A1  - Duma, M.
A1  - Eble, M. J.
A1  - Ernst, I.
A1  - Gerum, S.
A1  - Habermehl, D.
A1  - Hass, P.
A1  - Henkenberens, C.
A1  - Hildebrandt, G.
A1  - Imhoff, D.
A1  - Kahl, H.
A1  - Klass, N. D.
A1  - Krempien, R.
A1  - Lewitzki, V.
A1  - Lohaus, F.
A1  - Ostheimer, C.
A1  - Papachristofilou, A.
A1  - Petersen, C.
A1  - Rieber, J.
A1  - Schneider, T.
A1  - Schrade, E.
A1  - Semrau, R.
A1  - Wachter, S.
A1  - Wittig, A.
A1  - Guckenberger, M.
A1  - Andratschke, N.
T1  - The impact of local control on overall survival after stereotactic body radiotherapy for liver and lung metastases from colorectal cancer: a combined analysis of 388 patients with 500 metastases
JF  - BMC Cancer
N2  - Background
The aim of this analysis was to model the effect of local control (LC) on overall survival (OS) in patients treated with stereotactic body radiotherapy (SBRT) for liver or lung metastases from colorectal cancer.

Methods
The analysis is based on pooled data from two retrospective SBRT databases for pulmonary and hepatic metastases from 27 centers from Germany and Switzerland. Only patients with metastases from colorectal cancer were considered to avoid histology as a confounding factor. An illness-death model was employed to model the relationship between LC and OS.

Results
Three hundred eighty-eight patients with 500 metastatic lesions (lung n = 209, liver n = 291) were included and analyzed. Median follow-up time for local recurrence assessment was 12.1 months. Ninety-nine patients with 112 lesions experienced local failure. Seventy-one of these patients died after local failure. Median survival time was 27.9 months in all patients and 25.4 months versus 30.6 months in patients with and without local failure after SBRT. The baseline risk of death after local failure exceeds the baseline risk of death without local failure at 10 months indicating better survival with LC.

Conclusion
In CRC patients with lung or liver metastases, our findings suggest improved long-term OS by achieving metastatic disease control using SBRT in patients with a projected OS estimate of > 12 months.
KW  - colorectal cancer
KW  - illness-death model
KW  - liver metastases
KW  - lung metastases
KW  - tumor control probability
KW  - stereotactic body radiation therapy
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-325877
VL  - 19
ER  -