How do you approach SBRT liver constraints when the total liver volume is <700 cc?

Topics: Radiation Oncology • Gastrointestinal Cancers

Liver SBRT maintaining 700 ccs of liver <15 Gy is a commonly used constrain; however, if the total liver volume is limited due to cirrhosis, prior resection or other causes, how do you approach liver constraints?

Answer from: Radiation Oncologist at Academic Institution

We consider 3 different methods of thinking about liver constraints when evaluating a plan: 1) Sparing 700 cc's to < 15 Gy (for 3 fractions), and <17 Gy (for 5 fractions). 2) Liver mean dose constraints (as in RTOG 1112 for CP A cirrhosis, <14 Gy), and <15-16 Gy for non-cirrhot...

Comments

Radiation Oncologist at Medical College of Wisconsin
This response makes a lot of sense, thank you. The...

Answer from: Radiation Oncologist at Academic Institution

I'm not aware of data that addresses this question. My understanding is that our constraint of sparing 700 cc of liver is extrapolated from surgical data, in which this is considered the minimal volume of residual liver required for adequate hepatic function following a partial hepatectomy. My pract...

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