Stereotactic body radiotherapy using the CyberKnife^® system in the treatment of patients with liver metastases: state of the art

Figures & data

Figure 1 Cyberknife^® Robotic System and its components. 1. Robotized arm, 2. linear accelerator, 3. X-ray imaging, 4. X-ray detectors, 5. Robocouch™ table.

Table 1 Summary of SBRT using the CyberKnife^® system in the treatment of patients with liver metastases

Reference	Study year	Number of patients (number of lesions)	Tumor volume	Primary site of metastases	RT dose	Clinical outcomes
Aitken et al^Citation34	2015	73 (87)	0.2–110.4 mL (median 6.34 mL)	Mixed	21–60 Gy in 3–5 fractions	2-year LC 89.6% 2-year survival 79.8%
Berkovic et al^Citation10	2017	42 (55)	30.5–96.8 mL	Mixed (mostly CRC)	45 Gy in 3 fractions	1-year LC 81.3% 2-year LC 76.3% 2-year survival 78.3%
Dewas et al^Citation31	2012	120 (153)	0.5–11.2 cm (median 3.3 cm)	Mixed (mostly HCC and CRC)	27–45 Gy in 3–4 fractions	1-year LC 84% 2-year LC 74.6% 2-year survival 58.3%
Fumagalli et al^Citation32	2012	90 (139)	0.7–11.0 cm (median 2.8 cm)	Mixed (mostly CRC, breast, and lung)	27–60 Gy in 3–6 fractions	1-year LC 84.5% 2-year LC 66.1% 2-year survival 70%
Goodman et al^Citation35	2016	81 (106)	0.9–10.2 cm (median 2.7 cm)	Mixed (mostly CRC)	30–60 Gy in 3–5 fractions	1-year LC 96% 2-year LC 91% Median survival 33.6 months
Chang et al^Citation24	2011	65 (102)	0.6–3,088 mL (median 30.1 mL)	CRC	22–60 Gy in 1–6 fractions	1-year LC 62% 2-year LC 45% 1-year survival 72%
Kress et al^Citation23	2012	11 (14)	21–225 mL (median 99.7 mL)	CRC	16–42 Gy in 2–5 fractions	1-year LC 72% Median survival 16.1 months
Lee et al^Citation29	2009	68 (143)	1.2–3,090 mL (median 75.9 mL)	Mixed (mostly CRC and breast)	27–60 Gy in 6 fractions	1-year LC 71% Median survival 17.6 months
McPartlin et al^Citation33	2017	60 (105)	0.6–403.5 mL (median 40.8 mL)	CRC	22.7–62.1 Gy in 6 fractions	1-year LC 50% 2-year LC 32% Median survival 16.0 months
Rule et al^Citation25	2011	27 (37)	0.4–7.8 cm (median 2.5 cm)	Mixed (mostly CRC)	30–60 Gy in 3–5 fractions	2-year survival 56%–100%
Rusthoven et al^Citation30	2009	47 (63)	0.7–98 mL (median 14.9 mL)	Mixed (mostly CRC and lung)	36–60 Gy in 3 fractions	1-year LC 95% 2-year LC 92% Median survival 20.5 months
Yuan et al^Citation11	2014	57 (80)	2.5–125.6 mL (median 27.6 mL)	Mixed (mostly CRC, pancreatic, breast, and lung)	39–54 Gy in 3–7 fractions	1-year LC 94.4% 2-year LC 89.7% Median survival 37.5 months
Van der Pool et al^Citation27	2010	20 (31)	0.7–6.2 cm (median 2.3 cm)	CRC	30–37.5 Gy in 3 fractions	1-year LC 100% 2-year LC 74% Median survival 34 months
Vautravers-Dewas et al^Citation26	2011	42 (62)	0.7–10.0 cm (median 3.4 cm)	Mixed (mostly CRC)	40–45 Gy in 3–4 fractions	1-year LC 90% 2-year LC 86% 2-year survival 48%

Abbreviations: SBRT, stereotactic body radiotherapy; RT, radiotherapy; LC, local control; HCC, hepatocellular carcinoma; CRC, colorectal cancer.

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