Managing liver metastases with conformal radiation therapy.
A subgroup of liver metastases, especially those emanating from colorectal carcinoma, may be cured. Surgical excision is accepted as the mainstay of treatment for these malignancies; unfortunately, however, the majority of patients presents with advanced unresectable hepatic involvement and have no standard treatment option available. Radiation therapy (RT) has not played a significant role in managing liver metastases, because the liver has little tolerance to radiation. In patients with good hepatic function, however, very-high-dose RT may be used safely and effectively if a small volume of the liver (< 25%) is irradiated. In particular, RT, and especially three-dimensional conformal RT (3D-CRT), may be used to manage medically unfit patients or those with an unresectable metastatic liver lesion. This review discusses existing literature on use of various types of RT, including whole-liver irradiation, partial hepatic irradiation with 3D-CRT, and hypofractionated high-dose irradiation with stereotactic body RT, and future directions for this treatment modality.
Topkan
Erkan
E
Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey. drerkantopkan@yahoo.com
Onal
Huseyin Cem
HC
Yavuz
Melek Nur
MN
D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal; D013238:Stereotaxic Techniques