Stereotactic radiation therapy of liver metastases

Purpose. A number of minimal-invasive methods have been developed for the t reatment of non-resectable liver metastases. A focused high dose can be del ivered to a liver tumor with sparing of surrounding normal liver tissue usi ng non-invasive stereotactic techniques. Methods. Sixty-six metastases were treated stereotactically in 43 patients during a phase 2 trial. Results. There were no major side effects observed. The actuarial local con trol was 82% after 18 months. The median actuarial survival was 24 months. However, there was a significantly improved survival in patients without ad ditional extrahepatic tumor manifestation at the time of treatment compared to those, who were treated in palliative intention (87% vs. 24% after 18 m onths, p=0.001 (log-rank). Conclusion. Stereotactic single dose irradiation is a non-invasive and safe treatment option for patients with inoperable liver metastases. Phase III studies will further evaluate this new approach.