Stereotactic Radiotherapy for Liver Metastases

Abstract

Liver metastases are common in oncologic patients, causing substantial morbidity and mortality. Systemic therapy is now standard palliative treatment for most patients with liver metastases, often providing transient responses and increased overall survival. In selected oligometastatic patients, local treatment can lead to long disease-free intervals and even permanent disease control. Although surgery remains the gold standard of local treatments, most patients will not be appropriate surgical candidates. For these patients, alternate local treatments have been developed. Among these, stereotactic body radiotherapy (SBRT) presents an attractive non-invasive option for selected patients with limited hepatic involvement. This article reviews the development, indications, methods, and results of SBRT in the management of liver metastases.

Liver Metastasis–Directed Ablative Radiotherapy in Pancreatic Cancer Offers Prolonged Time Off Systemic Therapy in Selected Patients

“…Stereotactic body radiotherapy is also a safer alternative to a metastasectomy, which carries surgical risks. 33 Stereotactic body RT is preferred over radiofrequency ablation or transcatheter arterial chemoembolization in patients who previously underwent Whipple procedure given the high risk of hepatic abscess formation. 34,35 Prospective studies have demonstrated that SBRT is a safe and effective treatment modality for LM.…”

“…High-dose ablative RT such as SBRT may be a therapeutic option for inoperable LM or patients who are not surgical candidates, which is the case in the majority of MPC patients. Stereotactic body radiotherapy is also a safer alternative to a metastasectomy, which carries surgical risks 33 . Stereotactic body RT is preferred over radiofrequency ablation or transcatheter arterial chemoembolization in patients who previously underwent Whipple procedure given the high risk of hepatic abscess formation 34,35 .…”