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Safety and Efficacy of Liver Stereotactic Radiation Therapy in Elderly Patients.

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Title: Safety and Efficacy of Liver Stereotactic Radiation Therapy in Elderly Patients.
Authors: Lewy, J.R.1 (AUTHOR), Schipper, M.2,3 (AUTHOR), Evans, J.R.3 (AUTHOR), Patil, P.1 (AUTHOR), Lawrence, T.S.3 (AUTHOR), Cuneo, K.C.3 (AUTHOR)
Source: International Journal of Radiation Oncology, Biology, Physics. 2022 Supplement, Vol. 114 Issue 3, pe176-e177. 2p.
Subjects: Older patients, Radiotherapy, Hepatotoxicology, Liver cancer, Liver, Radiation injuries
Abstract: While radiation-related liver toxicity is a well-studied concern for patients with liver cancer who receive radiotherapy, few studies have specifically investigated the relationship between age and toxicity. We sought to examine treatment tolerance and efficacy in a cohort of elderly (≥ 70 years old) patients who received stereotactic radiation therapy (SBRT) for liver malignancies A single-institution liver cancer database was queried for patients 70 years or older with follow-up imaging treated with radiation between 2/2005 and 1/2021. The database was further refined by patients with pre-treatment Child-Pugh scores recorded. Patients who were treated sequentially or concurrently for multiple tumors were considered to have had a single course of SBRT. Toxicity was defined as an increase in Child-Pugh score of ≥ 2 points within 6 months after a course of radiation. Freedom for local failure and overall survival were calculated using the Kaplan-Meier method. Local control was determined for each lesion treated. There were 108 individual patients with follow-up imaging who received at least one course of radiation. Patient characteristics are shown in Table 1. In total, there were 32 toxicity events over 126 radiation courses (25.4%). CPA patients had 22 toxicity events over 98 courses (22.4%), while CPB and CPC patients had 10 toxicity events over 28 courses (35.7%). Closer analysis of CPA patients based on those with a score of 5 (CPA5) vs. 6 (CPA6) results as CPA5 with 11 toxicities over 72 radiation courses (15.3%) and CPA6 with 11 toxicities over 28 courses (42.3%). Lesion local control rates were 90.2% at 1 year and 81.4% at 2 years. Overall survival was 69.1% at 1 year and 44.9% at 2 years. In elderly patients with liver cancer and a baseline Child-Pugh score of 5, SBRT is relatively safe regarding liver toxicity and effective in terms of local control. However, the risk of toxicity greatly increases for those with a baseline Child-Pugh score ≥ 6. These results suggest further examination of baseline prognosis, treatment tolerance, and outcome is warranted among elderly patients with liver malignancies treated with SBRT. [ABSTRACT FROM AUTHOR]
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Abstract:While radiation-related liver toxicity is a well-studied concern for patients with liver cancer who receive radiotherapy, few studies have specifically investigated the relationship between age and toxicity. We sought to examine treatment tolerance and efficacy in a cohort of elderly (≥ 70 years old) patients who received stereotactic radiation therapy (SBRT) for liver malignancies A single-institution liver cancer database was queried for patients 70 years or older with follow-up imaging treated with radiation between 2/2005 and 1/2021. The database was further refined by patients with pre-treatment Child-Pugh scores recorded. Patients who were treated sequentially or concurrently for multiple tumors were considered to have had a single course of SBRT. Toxicity was defined as an increase in Child-Pugh score of ≥ 2 points within 6 months after a course of radiation. Freedom for local failure and overall survival were calculated using the Kaplan-Meier method. Local control was determined for each lesion treated. There were 108 individual patients with follow-up imaging who received at least one course of radiation. Patient characteristics are shown in Table 1. In total, there were 32 toxicity events over 126 radiation courses (25.4%). CPA patients had 22 toxicity events over 98 courses (22.4%), while CPB and CPC patients had 10 toxicity events over 28 courses (35.7%). Closer analysis of CPA patients based on those with a score of 5 (CPA5) vs. 6 (CPA6) results as CPA5 with 11 toxicities over 72 radiation courses (15.3%) and CPA6 with 11 toxicities over 28 courses (42.3%). Lesion local control rates were 90.2% at 1 year and 81.4% at 2 years. Overall survival was 69.1% at 1 year and 44.9% at 2 years. In elderly patients with liver cancer and a baseline Child-Pugh score of 5, SBRT is relatively safe regarding liver toxicity and effective in terms of local control. However, the risk of toxicity greatly increases for those with a baseline Child-Pugh score ≥ 6. These results suggest further examination of baseline prognosis, treatment tolerance, and outcome is warranted among elderly patients with liver malignancies treated with SBRT. [ABSTRACT FROM AUTHOR]
ISSN:03603016
DOI:10.1016/j.ijrobp.2022.07.1067