Radiation to the liver for hepatic metastases from colorectal cancer: Stereotactic radiotherapy and radioactive microspheres

Abstract

Local therapy for colorectal cancer metastatic to the liver has been shown to palliate symptoms, prolong life, and (in select cases) serve as a cure. Minimal and noninvasive approaches have increased in popularity and may be a good alternative to surgical resection. Traditionally, the use of fractionated external beam radiotherapy to the liver has been limited because of a high risk of toxicity. However, recent technologic advances have provided patients with a safer but still locally aggressive treatment modality that incorporates ionizing radiation: stereotactic body radiotherapy. In addition, selective internal radiation therapy with radioactive microspheres is another minimally invasive treatment alternative for liver tumors that are not amenable to aggressive local therapy with surgery or stereotactic body radiotherapy. In this article, we discuss the clinical implementation and selected research findings supporting the use of these treatment modalities.