Feasibility of Treatment of Cancer Involving the Liver With High Dose Radiation

Inclusion criteria

• Patients must have new hepatic lesions suggestive of metastasis, or otherwise biopsy proven disease if there is no previously negative scan.
• Patients with chemotherapy responsive or resistant disease are acceptable. Primary hepatobiliary tumors are also acceptable. In each case, the patient must be deemed unresectable by a hepatic surgeon.
• Patients with multiple hepatic lesions may be included if they meet the volumetric criteria for dose specification. Likewise, patients with metastases to organs other than the liver, or patients with residual primary disease may be included if it is judged that longevity will be determined by the hepatic disease.
• KPS ≥70
• Age ≥ 18 years
• Bilirubin <2.0 mg/dl, AST < 2.5 x normal, ALT < 2.5 x normal, Platelets > 80,000/mm3
• Chemotherapy treatment before or after radiation will be allowed
• Informed consent must be obtained., Patient must be judged unresectable by a hepatic surgeon, or must have refused surgery
• Patient must be able to tolerate radiation treatment as judged by the Principal Investigator or co-PI.
• Previous Liver resection is allowed
• Active disease outside the liver is allowed.
• Liver lesion should be visible on CT or MRI.

Exclusion criteria

• No active hepatitis or radiographic evidence of diffuse macro-nodular cirrhosis. Patients with lesser degrees of cirrhosis, not associated with portal hypertension or hepatic failure, are eligible but radiation schedule and total dose will be appropriately modified.
• Women who are pregnant