Stereotactic body radiation therapy (SBRT) for liver metastases: A clinical review

For over half a century, conventionally fractionated whole-liver radiation has been used for the palliation of diffuse, symptomatic liver metastases. More recently, interest has grown in identifying subsets of patients with a limited disease burden where focal ablation of metastases may improve disease control and prolong survival. Although promising outcomes have been reached following resection of liver metastases, most patients are not resection candidates. Stereotactic body radiation therapy (SBRT) is a modern technique for the delivery of ablative, high-dose external beam radiation with subcentimeter accuracy. SBRT is supported by a large body of prospective clinical trials and has emerged as a highly effective, safe, and non-invasive therapy for hepatic metastases. The following review examines the evolution of hepatic radiation, focusing on the emergence of SBRT and its associated outcomes and clinical considerations.