Liver metastases is a common occurrence in cancers of gastrointestinal tract ,lung and breast cancer.Typically the median survival in such cases is 6 -12 months without intervention.
Treatment includes surgery if solitary metastases is present, palliative chemotherapy for unresectable lesions, and alternative therapy like embolization and cryoablation if possible.
Newer and more advanced treatment for liver metastases is Stereotactic body radiotherapy (SBRT) is a non- invasive local therapy for lesions non amenable to surgery. SBRT is a very high precision radiation given to Target only the metastases with high radiation doses so as to kill the tumor cells and simultaneously save the surrounding critical organs from the side effects of radiation. In other words, it acts like the knife of the surgeon but is non invasive.
For the patient to be treated with SBRT, certain criteria is needed. The size of the lesion should be less than 6 cm, number of metastases should be less than 3, patient should be in good general condition, liver function tests Should be within normal limits and the primary tumor should be controlled with a good life expectancy.
The radiation dose given is usually 30-60 Gy in 3 sittings. The local control rates are between 60-90 percent. Grade 3-4 toxicity is seen in 1-10 Percent. Liver function tests are repeated every month and CT scans are done 3-6 monthly to see the response.
So SBRT is a good treatment option for select patients with liver metastases
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