Dosimetric comparison of brachyablation and stereotactic ablative body radiotherapy in the treatment of liver metastasis

J Daniel Pennington; Sang June Park; Narine Abgaryan; Robyn Banerjee; Percy P Lee; Christopher Loh; Edward Lee; D Jeffrey Demanes; Mitchell Kamrava

doi:10.1016/j.brachy.2015.04.002

Dosimetric comparison of brachyablation and stereotactic ablative body radiotherapy in the treatment of liver metastasis

Brachytherapy. 2015 Jul-Aug;14(4):537-42. doi: 10.1016/j.brachy.2015.04.002. Epub 2015 May 2.

Authors

J Daniel Pennington¹, Sang June Park¹, Narine Abgaryan¹, Robyn Banerjee¹, Percy P Lee¹, Christopher Loh², Edward Lee², D Jeffrey Demanes¹, Mitchell Kamrava³

Affiliations

¹ Department of Radiation Oncology, UCLA Medical Center, Los Angeles, CA.
² Department of Interventional Radiology, UCLA Medical Center, Los Angeles, CA.
³ Department of Radiation Oncology, UCLA Medical Center, Los Angeles, CA. Electronic address: MKamrava@mednet.ucla.edu.

PMID: 25944395
DOI: 10.1016/j.brachy.2015.04.002

Abstract

Purpose: We compared the dosimetry of brachyablation (BA) and stereotactic ablative radiotherapy (SABR) in the treatment of liver metastases.

Methods and materials: Treatment plans for 10 consecutive liver metastasis patients, treated with SABR, were replanned for BA. BA treatment was planned using five 12 Gy fractions to the same planning target volume (PTV) used for SABR. Dosimetric parameters were compared using a Student's paired t test.

Results and conclusions: BA and SABR plans had similar mean volume receiving 100% of the prescribed dose (94.1% vs. 93.9% of PTV, p = 0.8). Mean volume receiving 150% of the prescribed dose for BA was 63.6%, whereas for SABR it was 0. The minimum dose to the PTV was 65.8% for BA, whereas for SABR it was 87.4% (p = 0.0002). Liver volume receiving ≥15 Gy was similar for BA and SABR (278 vs. 256 cc, p = 0.3). Small bowel mean dose, as percent prescription dose, was higher for BA (10.8% vs. 7.1%, p = 0.006). Stomach mean dose was similar (4.9% vs. 4.8% of prescription dose, p = 0.98). Right kidney mean dose was greater for BA (6.7% vs. 4.2%, p = 0.07). BA leads to a higher target dose, similar dose to organs at risk, but potentially with lower target coverage compared with SABR. Further work is needed to determine ideal suitability for mono vs. combination therapy with this approach.

Keywords: Brachyablation; Image guided brachytherapy; Liver metastasis; SABR; Stereotactic body radiotherapy.

Publication types

Comparative Study

MeSH terms

Ablation Techniques* / adverse effects
Aged
Brachytherapy / adverse effects
Brachytherapy / methods*
Dose Fractionation, Radiation
Female
Humans
Intestine, Small / radiation effects
Kidney / radiation effects
Liver / radiation effects
Liver Neoplasms / radiotherapy*
Liver Neoplasms / secondary
Male
Organs at Risk / radiation effects*
Radiation Injuries / prevention & control*
Radiosurgery / adverse effects
Radiosurgery / methods*
Radiotherapy Planning, Computer-Assisted
Stomach / radiation effects