ArticleClinical and translational radiation oncology2026
Daily adaptive MR-guided stereotactic ablative re-irradiation (re-SABR) in oligometastatic liver disease: A single-institution retrospective analysis.
Article in Clinical and translational radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Stereotactic ablative body radiotherapy (SABR) is an established treatment option in oligometastatic liver disease. Limited data exist on liver SABR re-irradiation (re-SABR). MR-guided SABR with daily plan adaptation and deformable image registration (DIR) allows organ-at-risk (OAR) sparing and dose accumulation in a re-irradiation setting. We report the safety and efficacy of MR-guided re-SABR in oligometastatic liver disease, alongside a DIR-based workflow for cumulative OAR dose calculation. Methods: MR-guided re-SABR to oligometastatic liver disease was retrospectively analysed. Key inclusion criteria included: prior liver SABR, MR-guided re-SABR to ≤ 4 liver metastases, Child Pugh Score (CPS) ≤ B7, and a minimum prescribed dose of 30 Gy in 5 fractions. Lesions were classified according to the ESTRO-EORTC re-irradiation consensus. Acute and delayed toxicity, local control (LC), local progression-free survival (LPFS), and overall survival (OS) were reported, overall and by primary tumour type. Cumulative OAR doses were estimated using a DIR-based as compared to a non-DIR-based workflow. Results: Between October 2020 and April 2024, twelve patients underwent MR-guided re-SABR to 18 liver metastases. While the majority (12/18) were colorectal in origin, other primaries included pancreas, breast, oesophagogastric, and ovary. 50% of lesions were type-1 re-irradiation (including 3 repeated target irradiations).Median prescription BED Conclusion: With the limitation of relatively low patient numbers and mixed tumour histology, MR-guided re-SABR to oligometastatic liver disease appeared well tolerated, achieving high LC rates. DIR-based workflow predicted higher cumulative OAR doses, potentially further improving the safety of liver re-SABR.
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