Individualized Stereotactic Body Radiotherapy of Liver Metastases

Phase II Study of Individualized Stereotactic Body Radiotherapy of Liver Metastases

Stereotactic body radiation therapy (SBRT) is a technique that is used to deliver radiation, to sites in the body. All participants in this study will be treated with SBRT using proton beam radiation. Proton beam radiation uses tiny particles to deliver radiation to tumors. The purpose of this research study is to determine if SBRT with protons will prevent tumor growth and reduce the treatment side effects for liver metastases.

Study Overview

• Status: Completed
• Conditions: Solid Tumor; Liver Metastases
• Intervention / Treatment: Radiation: Stereotactic body radiotherapy-proton

Detailed Description

• Participants receiving SBRT with protons, will receive radiation treatment as an outpatient at the Francis H. Burr Proton Therapy Center at Massachusetts General Hospital.
• Not everyone who participates in this study will be receiving the same dose of radiation. The dose received will be determined by the size and location of the tumor(s).
• Participants will receive 2-3 SBRT treatments per week for two weeks.
• During radiation therapy visits the following tests/procedures will be performed: vital signs, physical examination, routine blood tests, research blood tests, and radiation planning.
• Follow-up assessments will be performed once at 9 weeks after study treatment, then at 6 months, 12 months, 18 months and 24 months after treatment.

• Study Type: Interventional
• Enrollment (Actual): 92
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02114
      • Massachusetts General Hospital
    • Boston, Massachusetts, United States, 02115
      • Dana-Farber Cancer Institue

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Biopsy-proven cancer diagnosis of a solid tumor with 1-4 liver metastases. There is no upper size limit. Liver metastases may be diagnosed by imaging alone, no liver biopsy is required. Extrahepatic disease is allowed if it have been stable for 3 months prior to study entry, the dominant disease burden is intrahepatic and the patient is referred for definitive radiation therapy to the disease in the liver
• Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension as 10mm or greater with spiral CT scan
• Patients may have had prior chemotherapy, targeted biological therapy, surgery, transarterial chemoembolization (TACE), radiofrequency ablation, or cryosurgery for their disease as long as the prior therapy occured greater than 3 weeks elapsed before the first radiation treatment. Patients may not have had prior liver directed radiation, including radioembolization.
• 18 years of age or older
• Expected survival must be greater than three months
• Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
• Patients must have at least 800mL of uninvolved liver
• Normal organ and marrow function as outlined in the protocol
• If patient has underlying cirrhosis, only Child-Pugh classification Group A patients should be included in this study. Clinical assessment of ascites and encephalopathy is required. Child-Pugh classification must be determined for all study participants at the time of eligibility analysis.
• Women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation

Exclusion Criteria:

• Women who are pregnant or lactating
• Patients with gross ascites or encephalopathy
• Local conditions or systemic illnesses which would reduce the local tolerance to radiation treatment, such as serious local injuries, active collagen vascular disease, etc.
• Prior liver directed radiation treatment, including selective internal radiation
• No serious medical illness, which may limit survival to less than 3 months
• No serious psychiatric illness which would limit compliance with treatment
• Participants who have had chemotherapy or radiotherapy within 3 weeks prior to starting study treatment or those who have not recovered from adverse events due to agents administered more than 3 weeks earlier
• Participants may not be receiving any other investigational agents, or any other anti-cancer therapy during treatment
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia.
• Only solid tumors are permitted. Thus, individuals with a liver mass from a diagnosis of lymphoma or leukemia are excluded

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SBRT-Proton; Stereotactic body radiotherapy by proton radiation	Radiation: Stereotactic body radiotherapy-proton; Dose will be determined by the size and location of the tumor(s); 2-3 treatments per week for two weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Local Control Rate	The percentage of participants with local control at primary tumor site at one year. Local is evaluated using Response Evaluation Criteria In Solid Tumors (RECIST). Local control is defined as achieving either Complete response (CR), Partial Response (PR), or Stable Disease (SD).; (CR): Disappearance of entire lesion, with no additional evidence of disease.; (PR): At least a 30% decrease in the (sum of) the longest diameter (LD) of the primary lesion, taken as reference the baseline sum LD.; (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started.	1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Median Follow-up Time	The median follow-up time among the 39 participants still alive at the time of analysis, measured from the start of treatment until the time of analysis.	1 year
Median Overall Survival	The median overall survival (in months) of participants as measured from the start of treatment.	2 years
Median Progression Free Survival	The median amount of time participants survived without cancer progression following the start of study treatment. Progression was assessed using RECIST v1.0. Progressive Disease (PD) is defined as at least a 20% increase in the Longest Diameter (LD) of the lesion, taken as the reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.	1 years
2-year Local Control Rate	The percentage of participants with local control 2 years after the start of study treatment.	2 years
1 Year Local Control Rate Among Participants With Colorectal Cancer	The percentage of participants with local control at one year among the participants with colorectal cancer as the primary cancer.	1 year
Median Survival Among Participants With Colorectal Cancer	The median amount of time participants survived from the start of treatment, among the participants with colorectal cancer.	2 years

Collaborators and Investigators

• Sponsor: Massachusetts General Hospital
• Collaborators: National Cancer Institute (NCI); Dana-Farber Cancer Institute; Brigham and Women's Hospital
• Investigators: Principal Investigator: Hannah J. Roberts, MD, Massachusetts General Hospital

Publications and helpful links

General Publications

• Hong TS, Wo JY, Borger DR, Yeap BY, McDonnell EI, Willers H, Blaszkowsky LS, Kwak EL, Allen JN, Clark JW, Tanguturi S, Goyal L, Murphy JE, Wolfgang JA, Drapek LC, Arellano RS, Mamon HJ, Mullen JT, Tanabe KK, Ferrone CR, Ryan DP, Iafrate AJ, DeLaney TF, Zhu AX. Phase II Study of Proton-Based Stereotactic Body Radiation Therapy for Liver Metastases: Importance of Tumor Genotype. J Natl Cancer Inst. 2017 Sep 1;109(9). doi: 10.1093/jnci/djx031.

Study record dates

Study Major Dates

• Study Start (Actual): October 5, 2010
• Primary Completion (Actual): January 1, 2016
• Study Completion (Actual): September 1, 2017

Study Registration Dates

• First Submitted: June 14, 2010
• First Submitted That Met QC Criteria: November 10, 2010
• First Posted (Estimated): November 11, 2010

Study Record Updates

• Last Update Posted (Estimated): September 30, 2025
• Last Update Submitted That Met QC Criteria: September 11, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: stereotactic body radiotherapy; SBRT; proton radiation
• Additional Relevant MeSH Terms: Digestive System Diseases; Pathologic Processes; Neoplasms; Neoplasms by Site; Digestive System Neoplasms; Liver Diseases; Neoplastic Processes; Neoplasm Metastasis; Liver Neoplasms
• Other Study ID Numbers: 10-139; Other (Other Identifier: GENERATION HD2)