Radiobiological parameters of liver and lung metastases derived from tumor control data of 3719 metastases

Radiother Oncol. 2017 May;123(2):218-226. doi: 10.1016/j.radonc.2017.03.014. Epub 2017 Mar 28.

Abstract

Background and purpose: The radiobiological parameters for liver and lung metastases treated with stereotactic body radiation therapy (SBRT) are poorly defined. This project aimed at estimating these parameters from published tumor control probability (TCP) data, and separately for metastases with colorectal cancer (CRC) and non-CRC histology.

Materials and methods: A total of 62 studies with 89 different treatment prescriptions for a total of 3719 metastases were analyzed in a Bayesian framework using four different radiobiological models: The LQ, mLQ, LQ-L and the regrowth model which accounts for tumor regrowth after SBRT.

Results: Depending on the particular model, α/β ratios in the range 13-23Gy for pulmonary metastases and 16-28Gy for hepatic metastases were estimated. For CRC metastases the estimated α/β ratio was 43.1±4.7Gy compared to 21.6±7.8Gy for non-CRC metastases. Typical isocenter dose prescriptions of 3×12Gy, 3×14.5Gy and 3×17Gy applied within 5days were predicted sufficient to control 90% of lung, liver and CRC metastases after 1yr, respectively.

Conclusions: α/β ratios for liver and lung metastases are higher than the usually assumed 10Gy. Differences between CRC and non-CRC histology were found. Future studies confirming these findings in individual patient data are needed.

Keywords: Bayesian modeling; Metastases; Radiobiology; SBRT; Tumor control probability.

MeSH terms

  • Aged
  • Bayes Theorem
  • Carcinoma, Non-Small-Cell Lung / radiotherapy
  • Colorectal Neoplasms / pathology*
  • Humans
  • Liver Neoplasms / secondary*
  • Lung Neoplasms / radiotherapy
  • Lung Neoplasms / secondary*
  • Middle Aged
  • Radiobiology
  • Radiosurgery