Liver Cancer
Malignant tumors involving the liver take a variety of forms, including primary hepatocellular carcinoma, biliary neoplasms and liver metastases. The primary treatment for the majority of hepatobiliary neoplasms has been surgical resection, which represents potentially curative therapy, for primary or selected metastatic lesions. However, there are many circumstances under which surgery is not the best answer though. Possible surgical contraindications include inoperability, patient inability to withstand the surgical procedure, or additional malignant activity elsewhere in the body that renders aggressive surgical therapy inappropriate.
Many nonsurgical approaches have also been applied to unresectable hepatobiliary lesions, including radiofrequency ablation, cryoablation, chemoembolization, direct hepatic chemotherapeutic infusion, and systemic chemotherapy. Radiotherapy has also been used to treat hepatobiliary lesions. Traditional forms of radiotherapy have had a limited role in the management of hepatobiliary lesions, largely due to the fact that the liver parenchyma itself is very sensitive to radiation injury, particularly if a large volume of hepatic tissue is irradiated to a dose larger than 30Gy. Contemporary high dose conformal radiotherapy has yielded more meaningful and durable clinical responses in patients with hepatobiliary neoplasms, and the Cyberknife offer the best option to these types of liver aliments.
Stereotactic radiotherapy/radiosurgery allows a substantial radiation dose escalation to liver metastases, translating to a radiation biologic potency greater than double that of conventional radiation therapy approaches. This brings a new nonsurgical liver tumor ablation method that is more precise and powerful than traditional radiotherapy, and less invasive than resection, radiofrequency ablation or cryosurgery.
The unique CyberKnife dose sculpting and target tracking attributes make it a particularly attractive option for the treatment of liver metastatic lesions. As the only radiation delivery system that tracks respiratory tumor movement with 1.5 mm accuracy, the CyberKnife is uniquely capable of delivering an ablative radiation dose to liver metastases, with the sharpest margin possible, allowing the maximum possible sparing of adjacent normal hepatic parynchema and upper GI organs.
