Stereotactic body radiation therapy for liver metastases

Abstract

Over the years, early diagnosis of metastatic disease has improved and the prevalence of oligometastatic patients is increasing. Liver is a most common site of progression from gastrointestinal, lung and breast cancer and in the setting of oligometastatic patients, surgical resection is associated with increased survival. Approximately 70-90% of liver metastases, however, are unresectable and an effective and safe alternative therapeutic option is necessary for these patients. The role of stereotactic body radiation therapy (SBRT) was investigated in the treatment of oligometastatic patients with promising results, thanks to the ability of this procedure to deliver a conformal high dose of radiation to the target lesion and a minimal dose to surrounding critical tissues. This paper was performed to review the current literature and to provide the practice guidelines on the use of stereotactic body radiotherapy in the treatment of liver metastases. We performed a literature search using Medical Subject Heading terms "SBRT" and "liver metastases", considering a period of ten years.

Keywords: Liver metastases; oligometastases; stereotactic ablative radiotherapy (SABR); stereotactic body radiation therapy (SBRT).

Figure 1

Patient’s treatment algorithm. CT, computed tomography; PET, positron emission tomography; MRI, magnetic resonance imaging.

Figure 2

Example of complete metabolic response in a single hepatic lesion treated with SBRT. SBRT, stereotactic body radiation therapy.