MRI-guided SBRT prolongs survival in patients with liver tumour

Treatment with stereotactic body radiation therapy (SBRT) guided by magnetic resonance imaging (MRI) delivers optimal local control, resulting in better overall survival with an acceptable safety profile among heavily morbid, pretreated older patients with a liver tumour, reports a study.

Thirty-five patients (median age 70 years) who received MRI-guided SBRT from 2019 to 2021 for primary and metastatic liver tumours were included in the analysis, with a median follow-up of 19.4 months.

The overall survival (OS) at 1 year was 77.7 percent, with an estimated 3-year OS of 47.9 percent. Patients with locally controlled disease showed a better median OS of 27.8 months (95 percent confidence interval [CI], 23.8‒31.6) relative to only 13.5 months (95 percent CI, 5.6‒21.3; p=0.007) in those with local disease progression.

Freedom from local progression (FFLP) at 1 year was 95.6 percent, while the 3-year estimated FFLP stood at 87.1 percent. Patients treated with ≥100 Gy biologically equivalent dose had FFLP of 30.9 months (95 percent CI, 28.7‒33.1) as opposed to 13.3 months (95 percent CI, 5.3‒21.3; p=0.004) in those who received <100 Gy biologically equivalent dose.

In this study, the protocol for treatment simulation involved an injection with Gadoxetate disodium, followed by a single-dimensional postexhale MRI (0.35-T MRI linear accelerator) and computed tomography simulation. The investigators evaluated patient demographics and treatment-related outcomes. They also analysed the time-to-event curves for FFLP and OS.