[Radiotherapy of secondary liver cancers]

Indications for radiotherapy radiotherapy of hepatic metastases are limited. Only secondary hepatic focii in clinical or subclinical disseminated cancer of the ovary are systematically irradiated after curative chemotherapy. Liver radiotherapy in all patients with cancer of the ovary and its beneficial effect permitted a lifting of the longstanding ban on irradiation of this organ. Other indications are the hepatic metastases of lymphomas, seminomas, radiosensitive tumors and carcinoid tumors. For hepatic metastases of other histopathological origins, the indications are much more restrained. Principal interest is palliation of pain. High-energy cobalt 60 unit or linear accelerator delivered doses up to a maximum of 25 gray over 2 1/2 to 3 weeks in daily fractions through two portals of entry irradiating the total liver biomass. Use of flashes apparently must be eliminated because they may speed up the fatal outcome of disease in severe cancer patients. Radiotherapeutical tolerance is generally very satisfactory, nonetheless this depends upon the overall health picture in patients debilitated by disease and sometimes adjuvant chemotherapies. Finally, concomitant combination therapeutical modalities, such as local or regional chemotherapies administered by catheterisation of the hepatic artery associated with radiotherapy, have not yielded encouraging enough results to be proposed.