Intense investigation is ongoing regarding the question of how to treat liver mets. Available procedures include resection, the only proven modaity, trans-arterial catheter emblolization with or without chemotherapy, radiofrequency ablation, microwave or cryosurgery and vrioua radiation modalities. The best approach is under investigtion. The NCCN advised eitehr intre-hepatic chemotherapy or systemic chemotherapy; resection when possible is also a recommended option.
Stereotactic radiosurgery (SRS) is a method of delivering precise high doses of radiation to destroy targeted areas of abnormal tissue such as vascular malformations and malignant or benign tumors, while minimizing the amount of radiation delivered to surrounding normal tissue. Application to hepatic mets is limited by the low tolerance of liver to radiation and ongoing studies are attempting to identify the best approach.
In conclusion, the information from several early phase studies of radiosurgical approaches for liver metastses in colorectal cancer is insufficient to consider it estabshed or the best aproach.
Author(s): E. M. Anderson, A. Koong, G. Yang, I. C. Gibbs, G. A. Fisher, K. A. Goodman 2007 Gastrointestinal Cancers Symposium Abstract No: 171 Phase I dose escalation study of stereotactic radiosurgery for liver malignancies.
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