RATIONALE: Stereotactic radiation therapy may be able to send x-rays directly to the tumor
and cause less damage to normal tissue.
PURPOSE: This phase I trial is studying the side effects and best dose of stereotactic
radiation therapy in treating patients with liver metastases.
- To identify the maximum tolerated dose of stereotactic radiation therapy in patients
with hepatic metastases.
- To determine the toxicity and adverse events profile of this patient population.
- To examine patient response, treatment effect on blood chemistry, and hematology values
and patient quality-of-life in this patient population.
OUTLINE: Patients are stratified according to stereotactic radiotherapy level (1 vs 2 vs 3)
and the number of liver lesions present (1-2 vs 3-5 vs > 5).
Patients undergo percutaneous placement of metallic fiducial markers within the liver for
stereotactic targeting and planning. Patients then undergo 1 fraction of stereotactic
radiotherapy within 1 week of the marker placement.
Patients complete Brief Pain Inventory and Brief Fatigue Inventory questionnaires to assess
quality of life at weeks 2, 4, 6, 8 and months 3, 6, and 9 after completion of study
After completion of study treatment, patients are followed for at least 8 weeks.
- Metastatic liver lesion ≤ 5 cm in dimension
- Willing and able to undergo percutaneous placement of localization seeds
- ECOG performance status 0-1
- Life expectancy ≥ 12 weeks
- Platelet count ≥ 75,000/µL
- Hemoglobin ≥ 9 g/dL
- ANC ≥ 1,500/mL
- Total bilirubin ≤ 1.5 x upper limit of normal (ULN)
- AST ≤ 3 x ULN
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Able to complete questionnaires alone or with assistance
- No medical, social, or economic circumstance, that is likely to prevent adherence with
PRIOR CONCURRENT THERAPY:
- No prior radiation therapy to the liver
- No chemotherapy ≤ 4 weeks prior to registration
- Able to safely go without chemotherapy for 4 weeks after stereotactic radiotherapy
(e.g., patients must not have or need chemotherapy in the 8 weeks [4 weeks prior to
and 4 weeks after registration] surrounding stereotactic radiotherapy