Using CT-guided online adaptive radiation therapy (ART) for patients with liver tumors has proven to be an effective approach, according to findings presented today by Fox Chase Cancer Center researchers at the American Society for Radiation Oncology (ASTRO) Annual Meeting in Washington, D.C.

“We were interested in how well we were delivering radiation to the tumor and how well we’re avoiding organs at risk,” said Alexander Lukez, MD, the study’s lead author and a fourth-year resident in the Department of Radiation Oncology at Fox Chase.

The research team enrolled 13 patients with liver cancer or cancer that had metastasized to the liver in a retrospective registry study where physicians were offered either a scheduled plan, which is the conventional approach, or an ART plan.

ART is a treatment technique in which imaging and replanning of therapy can be done immediately before delivery of the treatment. This process is done in combination with a scheduled plan, which is created further in advance of treatment using imaging.

Once both of those processes are done, two different treatment plans are created—the scheduled plan created from the simulation and imaging, and the adaptive plan, which is updated based on the replanning done with same-day imaging. The two plans are compared, and the one deemed most effective is selected based on tumor coverage—how much radiation is delivered to the tumor—and how well surrounding tissue is spared.

“We looked at these plans and saw how much, if any, improvement there was with the adapted treatment versus the original scheduled plan. What we found was that the adapted plans tended to improve the tumor coverage as well as reduce the dose to the organs nearby,” said Lukez, who conducted the study with several Fox Chase colleagues.

“Additionally, we noted these differences were greater for a tumor that was closer to another organ. So, if we had a tumor that was quite close to another organ that we wanted to avoid, the adaptive plans were much better in those cases.”

Lukez said the researchers are interested in developing clinical trials that include multiple institutions to further evaluate outcomes that are clinically important for patients.

“For patients with liver tumors, I think this could be a good option and certainly is a way that we can attempt to minimize side effects from treatment while continuing to give a very high dose. It’s always a good idea for patients to see if they’re a candidate for this treatment, particularly if they have a tumor that can be treated with a short course of radiation and may be near another organ,” said Lukez.

The results of the study, which is entitled “CT-Guided Online Adaptive Stereotactic Body Radiation Therapy for Liver Tumors,” were presented during an oral presentation at the ASTRO meeting.

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Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence six consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.

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