Stereotactic body radiation therapy for abdominal oligometastases: a biological and clinical review
1 Department of Radiation Oncology, Integrated Oncology Centre, BD du Professeur Jacques MONOD, 44805, Saint-Herblain, France
2 INSERM UMR, Nantes-Angers Oncology Research Centre, 8 Quai Moncousu, BP 70721, 44007, Nantes cédex 1, France
Radiation Oncology 2012, 7:126 doi:10.1186/1748-717X-7-126Published: 1 August 2012
Advances in imaging and biological targeting have led to the development of stereotactic body radiation therapy (SBRT) as an alternative treatment of extracranial oligometastases. New radiobiological concepts, such as ceramide-induced endothelial apoptosis after hypofractionated high-dose SBRT, and the identification of patients with oligometastatic disease by microRNA expression may yet lead to further developments. Key factors in SBRT are delivery of a high dose per fraction, proper patient positioning, target localisation, and management of breathing–related motion. Our review addresses the radiation doses and schedules used to treat liver, abdominal lymph node (LN) and adrenal gland oligometastases and treatment outcomes. Reported local control (LC) rates for liver and abdominal LN oligometastases are high (median 2-year actuarial LC: 61 -100% for liver oligometastases; 4-year actuarial LC: 68% in a study of abdominal LN oligometastases). Early toxicity is low-to-moderate; late adverse effects are rare. SBRT of adrenal gland oligometastases shows promising results in the case of isolated lesions. In conclusion, properly conducted SBRT procedures are a safe and effective treatment option for abdominal oligometastases.