S982
Clinical - Oligometastatic cancer
ESTRO 2026
Results: Patients had a median age of 65.5 years (range, 32.6– 98.7) and predominantly exhibited ECOG performance status 0–1 (100%) with Child–Pugh class A liver function (96%). A single lung metastasis was present in 60.4%, and the median AFP level was 8.5 ng/mL (range, 0–35,960). The median overall survival was 2.8 years, with 2-, 5-, and 10-year survival rates of 63.1%, 32.7%, and 15.7%, respectively. On multivariable analysis, age ≥ 65 years, higher Child–Pugh score, extra-pulmonary metastasis, and AFP ≥ 20 ng/mL were independent predictors of poorer survival (p < 0.05 for all). Patients without extra-pulmonary metastasis and with AFP <20 ng/mL showed superior 2-year overall survival compared with others (77.0% vs 47.4%; p = 0.02; HR, 0.53; 95% CI, 0.32–0.89). In patients with extra- pulmonary metastasis or AFP ≥ 20 ng/mL, a favorable AFP response—defined as a ≥ 50% decline within 1 month after SABR completion—was associated with improved 2-year OS (61.5% vs 36.1%; p = 0.01). Across the entire cohort, local failure occurred in 3%, while distant progression developed in 87.1%, most commonly in the liver (53.5%) and lung (30.7%). Conclusion: SABR achieves durable local control and meaningful survival in selected patients with lung oligometastatic HCC. Metastatic burden and AFP dynamics are key predictors of outcome, underscoring their potential role in guiding patient selection for local therapy. References: Singal AG, Llovet JM, Yarchoan M, Mehta N, Heimbach JK, Dawson LA, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology. 2023 Dec;78(6):1922.Kim TH, Park S, Rim CH, Choi C, Seong J. Improved oncologic outcomes by ablative radiotherapy in patients with bone metastasis from hepatocellular carcinoma. J Cancer Res Clin Oncol. 2021 Feb 13;147(9):2693– 700.Kim K, Kim TH, Kim TH, Seong J. Efficacy of Local Therapy for Oligometastatic Hepatocellular Carcinoma: A Propensity Score Matched Analysis. J Hepatocell Carcinoma. 2021 Feb 11;8:35–44. Keywords: Hepatocellular carcinoma, Oligometastasis, SABR
distant progression-free survival was 29.1%. 2-year overall survival (OS) was 64.5%. Toxicities arose in 20 cases (41%). No grade ≥ 3 toxicity was recorded. Conclusion: We conclude that SBRT for hepatic metastases demonstrated high LC rates, especially with higher BED10 regimens and smaller ITVs, and good toxicity profiles. Our data are consistent with the literature (2- year LC 48-100%; OS 26-86%) [3]. The results also show comparable 2-year LC and OS with surgery (34- 85% and 23-55% respectively) [4-13]. References:
1. doi: 10.3389/fonc.2019.005432. doi: 10.1016/j.ijrobp.2017.07.0303. doi: 10.1016/j.prro.2024.09.0114. doi:10.1097/SLA.00000000000068845. doi:10.3390/jcm120621706. doi:10.1016/j.jamcollsurg.2011.12.0487. doi:10.1016/j.amjsurg.2017.09.0308. doi:10.1007/s00432-021-03631-59. doi:10.1016/j.ijsu.2016.04.00410. doi:10.1016/j.ijsu.2013.12.00211. doi:10.3390/jcm1202070412. doi:10.1016/j.ejso.2024.10858213. doi:10.1097/SLA.0000000000001542 Keywords: SBRT, SABR, Liver metastases
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SBRT for Lung Oligometastatic Hepatocellular Carcinoma : Outcomes and Prognostic Factors Soojin Lee 1 , Eui Kyu Chie 1 , Hyun-Cheol Kang 1 , Su Jong Yu 2 , Kyung Su Kim 1 1 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea, Republic of. 2 Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea, Republic of Purpose/Objective: Local therapy benefits several oligometastatic cancers, but its role in hepatocellular carcinoma (HCC) is uncertain. We assessed outcomes and prognostic factors in lung oligometastatic HCC treated with stereotactic ablative radiotherapy (SABR). Material/Methods: A retrospective analysis was conducted of 101 patients with lung oligometastatic HCC, defined as ≤ 5 lesions in ≤ 3 organs, treated with SABR at Seoul National University Hospital between 2011 and 2023. SABR was delivered to lung at a median dose of 54 Gy (range, 40–60 Gy) in 4–8 fractions. Survival analysis for overall survival was performed, defined from the end of radiotherapy to death. Prognostic factors were identified by Cox regression, and subgroup analyses were based on these factors using log-rank tests.
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Stereotactic MR-Guided Adaptive Radiotherapy (SMART) for Liver Metastases: Single Institution Experience Neris Dincer 1 , Ceren Atahan 1 , Anatolia Serkizyan 2 , Gorkem Gungor 1 , Gamze Ugurluer 1 , Banu Atalar 1 , Enis Ozyar 1 1 Radiation Oncology, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey.
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