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Introduction Methods Results Conclusion The aim of this study was to clarify the safety and efficacy of breath‐hold irradiation in liver stereotactic body radiotherapy (SBRT).A retrospective analysis was conducted on 57 consecutive patients who received SBRT for hepatocellular carcinoma or liver metastases between 2013 and 2021. Breath‐hold irradiation was implemented for patients treated after April 2020.The median follow‐up period for all patients was 16.4 months (IQR: 7.36–20.9). The 2‐year overall survival rate was 64.4% (95% CI: 47.4–77.2), and the local control rate was 84.3% (95% CI: 69.7–92.3) for all patients. The 1‐year overall survival was 80.0% (95% CI: 60.8–90.5) versus 82.0% (95% CI: 53.5–93.9) in the free‐respiratory (FR) group versus the breath‐hold (BH) group, respectively (P = 0.60). The 1‐year local control rates were 78.1% (95% CI: 57.5–89.5) in the FR group and 95.7% (95% CI: 72.9–99.4) in the BH group, respectively (P = 0.16). Radiation‐induced liver injury, defined by an escalation of ≥2 in Child–Pugh score, was observed in four patients within each group (FR 13% vs. BH 15%). There were no gastrointestinal adverse events of Grade 3 or higher.Breath‐hold irradiation can be safely administered and has demonstrated clinical potential in improving local control. Further research into dose escalation using breath‐hold techniques is warranted. [ABSTRACT FROM AUTHOR]

Background Breathing motion management is the key to delivering stereotactic body radiation therapy (SBRT) for liver lesions. This study aimed to compare the dosimetric parameters of liver SBRT using two different techniques: free breathing and breath hold. Method The study included 11 patients with liver metastases or hepatocellular carcinoma who underwent liver-directed SBRT. A dosimetric comparison was performed using dose-volume histogram analysis, evaluating parameters such as the maximum dose to 5 cc of bowel volume, mean liver dose (MLD), and liver V20 and V30. Statistical analyses were performed to compare results. Results The findings revealed that the breath hold technique resulted in significantly lower doses to the bowel and smaller volumes of normal liver tissue receiving 20 Gy (V20) and 30 Gy (V30) than the free breathing. Although there was no statistically significant difference in the MLD between the two techniques, the breath hold technique resulted in a lower MLD. Conclusion This dosimetric comparison study suggests that the breath hold technique is associated with lower radiation exposure to the bowel and normal liver tissues. Although this may not be feasible for all patients, it may be an appropriate procedure for selected individuals. Further research is needed to validate these findings in different patient populations and explore their impact on clinical outcomes and patient-reported quality of life., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Katano et al.)