External-beam radiotherapy in the management of liver metastases

This review discusses the importance of palliation of liver metastases. Although colorectal cancer comprises the majority of patients with metastatic liver disease, a number of other malignancies can be involved. Palliation of metastatic disease to liver has generally not included the use of external-beam radiotherapy because of restricted liver tolerance to radiotherapy. However, more recently, treatment policies have evolved to more generous use of palliative radiotherapy with utilization of tumor boost doses to partial liver volumes. This has resulted in improvement in palliation and a suggestion of improved survival with higher radiotherapy doses, which have been well tolerated by small volumes of liver.