Age

18–any

Sex

ALL

Healthy volunteers

Not accepted

Karnofsky Performance Scale (KPS) equal or greater than 70
1 to 4 liver metastases with an individual maximum diameter of up to 5 cm
Lesions considered unresectable or patients considered unfit for surgery
Histology of the primary tumor: colorectal adenocarcinoma, carcinoma of the anal canal or gastrointestinal neuroendocrine tumors.
Absence of evidence of extra-hepatic disease or extra-hepatic disease to be treated with curative intent.
Minimum interval of 2 weeks between systemic chemotherapy and SBRT.
Adequate bone marrow function defined as:
absolute neutrophils count \> 1,800 cells / mm 3
platelets \> 100,000 cells / mm 3
hemoglobin \> 8.0 g / dl ( transfusion or other intervention accepted)

Concomitant chemotherapy
Prior radiotherapy to the upper abdomen
Pregnancy
Underlying Cirrhosis
Active hepatitis or clinically significant liver failure
Prior invasive neoplasm except for non-melanoma skin cancer, or unless more than five years without evidence of disease
Severe Comorbidity
Current anticoagulant treatment

Stereotactic Body Radiation Therapy (SBRT) for Unresectable Liver Metastases