Stereotactic Body Radiation Therapy (SBRT) Efficiency and Toxicity in Liver Cancer

Patients will first go through an inclusion check-up consisting of:

• a clinical exam: disease history, previous treatments, weight, height, patient's performance status (ECOG) and HCC status.
• a biological test: biochemical (total bilirubin, ASAT-ALAT, LDH, albumin, alkaline phosphatases, GGT), hematological (if the patient is going to receive a fiducial), alphafoetoprotein (for HCC) and pregnancy test (if applicable)
• a tumor assessment: using a CT-scan or a MRI and using RECIST or mRECIST (if HCC), plus other morphological exams if judged useful by the investigator This check-up has to be realized within 28 days before inclusion. Then, the use of fiducial is optional.

Before the beginning of the treatment, a pre-therapeutic check-up is done:

• the inclusion check-up has to be done a second time if the treatment begins more than 28 days after the first one
• Tracking scanner.

The SBRT treatment is done in 3 to 6 times and no specific SBRT techniques are asked for, the investigator can choose according to the center habits.

After the treatment, a follow-up will be realized at 3, 6, 9, 12, 18, 24, 30 and 36 months and then once a year until the last patient included reach their 36th month of follow-up. The follow-up check-up consists of a clinical exam, biological test, tumor assessment and tolerance assessment.

Inclusion criteria

• Age ≥ 18 years old
• With primary or secondary liver tumor and matching one of the following situations:
• Liver Metastasis (LM): anatomopathologic diagnosis of the primary tumor
• Hepatocellular Carcinoma (HCC): diagnosis achieved through biopsy or through non-invasive methods approved by AASLD criteria (Bruix, 2011)
• Cholangiocarcinoma (CC): diagnosis achieved through biopsy
• Other primitive hepatic tumor achieved through biopsy
• Meet the requirements for SBRT treatment:
• Liver Metastasis (LM): oligometastatic disease
• Hepatocellular Carcinoma (HCC): non eligible lesion to curative surgery
• Cholangiocarcinoma (CC): nodular lesion
• Other primitive hepatic tumor: non eligible lesion to curative surgery
• Able to receive a SBRT treatment according to the multidisciplinary consultation meeting
• Tumor assessable with CT-scan or MRI according to mRECIST in HCC or Recist 1.1 in other situations
• Affiliation to the National Social Security System
• With informed and signed consent

Exclusion criteria

• Eligibility to a curative surgery according to the multidisciplinary consultation meeting
• Contraindication to SBRT (especially Cirrhose Child C)
• Pregnant or breastfeeding women
• Patient Under guardianship or tutorship
• Impossibility to submit at the study procedures due to geographic, social or mental reasons