Stereotactic body radiation therapy for liver tumors.

Recent improvements in radiation therapy delivery techniques provide new tools to treat patients with liver-confined disease, either with hepatocellular carcinoma or liver metastases. An appropriate selection of the patients made during a multidisciplinary specialized tumour board is mandatory. It should be based on the disease extension, an accurate evaluation of the comorbidities and the liver functions. The added value of this approach has to be evaluated in well-designed trials, alone or in combination with other treatments such as surgery, local treatments, chemoembolization and/or chemotherapy with or without targeted agents. Stereotactic body radiation therapy should be applied under strict conditions of expertise of the radiation oncology departments, including equipment and educational training programmes. However under these conditions, preliminary results seems highly encouraging in terms of local control and tolerance but should be confirmed in large controlled prospective trials.