The SBRT database initiative of the German Society for Radiation Oncology (DEGRO)
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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. / Andratschke, N; Alheid, H; Allgäuer, M; Becker, G; Blanck, O; Boda-Heggemann, J; Brunner, T; Duma, M; Gerum, S; Guckenberger, M; Hildebrandt, G; Klement, R J; Lewitzki, V; Ostheimer, C; Papachristofilou, A; Petersen, C; Schneider, T; Semrau, R; Wachter, S; Habermehl, D.
in: BMC CANCER, Jahrgang 18, Nr. 1, 13.03.2018, S. 283.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - The SBRT database initiative of the German Society for Radiation Oncology (DEGRO)
T2 - patterns of care and outcome analysis of stereotactic body radiotherapy (SBRT) for liver oligometastases in 474 patients with 623 metastases
AU - Andratschke, N
AU - Alheid, H
AU - Allgäuer, M
AU - Becker, G
AU - Blanck, O
AU - Boda-Heggemann, J
AU - Brunner, T
AU - Duma, M
AU - Gerum, S
AU - Guckenberger, M
AU - Hildebrandt, G
AU - Klement, R J
AU - Lewitzki, V
AU - Ostheimer, C
AU - Papachristofilou, A
AU - Petersen, C
AU - Schneider, T
AU - Semrau, R
AU - Wachter, S
AU - Habermehl, D
PY - 2018/3/13
Y1 - 2018/3/13
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.
AB - 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 - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Databases, Factual
KW - Dose Fractionation, Radiation
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Liver Neoplasms/secondary
KW - Male
KW - Middle Aged
KW - Neoplasms/pathology
KW - Practice Patterns, Physicians'
KW - Prognosis
KW - Radiosurgery/mortality
KW - Retrospective Studies
KW - Survival Rate
KW - Young Adult
U2 - 10.1186/s12885-018-4191-2
DO - 10.1186/s12885-018-4191-2
M3 - SCORING: Journal article
C2 - 29534687
VL - 18
SP - 283
JO - BMC CANCER
JF - BMC CANCER
SN - 1471-2407
IS - 1
ER -