Characterization of Chest Wall Toxicity After Stereotactic Body Radiation Therapy to the Liver.

PURPOSE/OBJECTIVE(S) Chest wall rib fractures are frequent complications after thoracic stereotactic body radiation therapy (SBRT). While well described for lung SBRT, limited data exists on the frequency and predictors for chest wall toxicity with SBRT to the liver for primary or metastatic lesions. We aimed to characterize the clinical, demographic and dosimetric factors of rib fractures. MATERIALS/METHODS A chart review identified 283 patients (204 male and 79 female) who received liver SBRT from 2014-2019. Univariate logistic regression models were used to identify demographic, clinical, and dosimetric factors associated with the development of rib fractures post liver SBRT. All statistical tests were two-sided and the null hypothesis was rejected for P 30 (P = 0.36) were not associated with the development of rib fractures. CONCLUSION Rib fractures after liver SBRT are a rare event and were observed in 8% of patients. Clinicians should continue to utilize well-established dose constraints and minimize radiation dose delivery to the chest wall.