Stereotactic Body Radiation Therapy (SBRT) for Unresectable Liver Metastases

Inclusion criteria

• Karnofsky Performance Scale (KPS) equal or greater than 70
• 1 to 4 liver metastases with an individual maximum diameter of up to 5 cm
• Lesions considered unresectable or patients considered unfit for surgery
• Histology of the primary tumor: colorectal adenocarcinoma, carcinoma of the anal canal or gastrointestinal neuroendocrine tumors.
• Absence of evidence of extra-hepatic disease or extra-hepatic disease to be treated with curative intent.
• Minimum interval of 2 weeks between systemic chemotherapy and SBRT.
• Adequate bone marrow function defined as:
• absolute neutrophils count > 1,800 cells / mm 3
• platelets > 100,000 cells / mm 3
• hemoglobin > 8.0 g / dl ( transfusion or other intervention accepted)

Exclusion criteria

• Concomitant chemotherapy
• Prior radiotherapy to the upper abdomen
• Pregnancy
• Underlying Cirrhosis
• Active hepatitis or clinically significant liver failure
• Prior invasive neoplasm except for non-melanoma skin cancer, or unless more than five years without evidence of disease
• Severe Comorbidity
• Current anticoagulant treatment