Radiation Therapy for Colorectal Liver Metastases

Purpose of Review: The purpose of the present study is to review the management of colorectal liver metastases (CLM) with radiation therapy (RT). Recent Findings: Conventional RT is a local-regional modality that may provide symptomatic palliation, local control, and potential for prolongation of survival. Studies of RT to the liver contributed to understanding of the volume effect of liver toxicity and the potential for dose escalation to limited volumes. Stereotactic body radiation therapy (SBRT) delivers highly conformal ablative doses, providing high rates of local control without associated increases in toxicity. Radioembolization can provide local control for chemorefractory patients, but its added value in the first-line setting with modern systemic therapy remains an area of active investigation. Summary: SBRT and radioembolization play key roles in the modern management of patients with CLM who are not eligible for surgery. Patients with limited burden of intrahepatic disease may be ideally suited for SBRT, while those with higher number (≥3) of CLM may be more appropriate for transarterial radioembolization.