Study of Stereotactic Body Radiation Therapy Using Tomotherapy for Metastatic Tumors to the Liver

Inclusion Criteria:

• Histologic confirmation of solid primary tumor metastatic to liver
• Age greater than or equal to 18 years old
• Zubrod performance status less than or equal to 1
• Negative pregnancy test for women of child bearing potential
• Informed consent
• Less than or equal to 3 liver metastases
• Each lesion must be less than or equal to 6 cm in maximal diameter
• No prior radiation to lesions being treated
• Patient is not a surgical candidate or refuses surgery
• Absolute neutrophil count ≥ 1800
• Platelets ≥ 100000
• Hemoglobin ≥8.0
• Systemic therapy (chemotherapy) completed at least 2 weeks prior to SBRT
• At time of radiation treatment planning, at least 700 cc of normal liver must receive less than 15 Gy

Exclusion Criteria:

• Contraindications to radiation
• Pregnant or lactating females who chose to breast feed
• Patients must have recovered from toxicity of prior therapy
• Any co morbid condition that' in the view of the attending physician' renders the patient at high risk from treatment complications
• Patients currently receiving anticoagulation with coumadin or IV heparin
• Liver cirrhosis
• Clinical ascites
• Bilirubin > 3, Albumin < 2.5, liver enzymes 3 times above normal, Creatinine > 1.8