Franzese Ciro, Louie Alexander V, Kotecha Rupesh, Zhang Zhenwei, Guckenberger Matthias, Kim Mi-Sook, Tree Alison C, Slotman Ben J, Sahgal Arjun, Scorsetti Marta
Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy.
Department of Radiation Oncology, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
Pract Radiat Oncol. 2025 Mar-Apr;15(2):e172-e188. doi: 10.1016/j.prro.2024.09.011. Epub 2024 Oct 16.
Liver metastases are a significant clinical challenge in cancer management, often representing a stage of disease in which curative treatment is still possible. Stereotactic body radiation therapy (SBRT) has emerged as a promising modality for treating these metastases, offering a noninvasive approach with potential for high efficacy. This systematic review and meta-analysis provides a comprehensive analysis of the efficacy and safety of SBRT in treating liver metastases, and practice recommendations are provided.
We performed a thorough literature review, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, and included 33 studies with a total of 3101 patients and 4437 liver metastases.
The review revealed pooled local control rates at 1, 2, and 3 years of 85%, 75%, and 68% respectively, while overall survival rates were 79%, 54%, and 37%. Grade 3 and 4 side effects occurred in only 3% of patients. The review of the studies highlighted the importance of factors such as primary tumor histology, lesion characteristics, and radiation dose in predicting treatment outcomes.
This review supports the growing body of evidence that SBRT is an efficacious and safe treatment option for liver metastases. It underscores the need for careful patient selection and personalized treatment planning to optimize outcomes.
肝转移是癌症治疗中的一项重大临床挑战,通常代表疾病的一个阶段,此时仍有可能进行根治性治疗。立体定向体部放射治疗(SBRT)已成为治疗这些转移瘤的一种有前景的方式,提供了一种具有高疗效潜力的非侵入性方法。本系统评价和荟萃分析对SBRT治疗肝转移的疗效和安全性进行了全面分析,并提供了实践建议。
我们按照系统评价和荟萃分析的首选报告项目进行了全面的文献综述,纳入了33项研究,共3101例患者和4437个肝转移灶。
该综述显示,1年、2年和3年的局部控制率分别为85%、75%和68%,而总生存率分别为79%、54%和37%。3级和4级副作用仅发生在3%的患者中。对这些研究的综述强调了原发性肿瘤组织学、病变特征和放射剂量等因素在预测治疗结果方面的重要性。
本综述支持越来越多的证据表明,SBRT是治疗肝转移的一种有效且安全的治疗选择。它强调了仔细选择患者和进行个性化治疗计划以优化治疗结果的必要性。