title: Liver metastases and SBRT: A new paradigm?
abstract: BACKGROUND
  The outstanding innovations made by early diagnosis, novel surgical techniques, effective chemotherapy regimens and conformal radiotherapy, have significantly improved patients overall survival and quality of life. Multidisciplinary approach to cancer has also led to an increased prevalence of patients with few, organ-confined metastases, who can experience long-term survival even if their disease is no longer localized. Liver is one of the most common site for metastatic disease from several cancers, and when metastatic disease is confined to liver, given the ability of this organ to regenerate almost to its optimal volume, surgical resection represents the standard of care because is associated with a better prognosis. Approximately 70-90% of liver metastases, however, are unresectable and a safe, effective alternative therapeutic option is necessary for these patients.
  
  
  METHODS
  A review of the current literature was performed to analyze the role of SBRT in treating liver metastases from different cancers. A literature search using the terms "SBRT" and "liver metastases" was carried out in PUBMED.
  
  
  RESULTS
  Stereotactic body radiation therapy has shown to provide promising results in the treatment of liver metastases, 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.
  
  
  CONCLUSIONS
  Stereotactic body radiation therapy is a non-invasive, well-tolerated and effective treatment for patients with liver metastases not suitable for surgical resection.
authors.affiliation: Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Rozzano, Milano, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Comito
authors.affiliation: Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Rozzano, Milano, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Clerici
authors.affiliation: Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Rozzano, Milano, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Tozzi
authors.affiliation: Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Rozzano, Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Agostino
keywords: Liver; Oligometastatic patients; SBRT