Terapia de Protones Estereotáctica Corporal para Metástasis Hepáticas: Factibilidad, Seguridad y Control Local

Fecha de inicio: 22 de agosto de 2012

Inclusion Criteria: Pathologically confirmed non-lymphoma liver metastases or New radiographic liver lesions consistent with metastases in patients with known pathologically confirmed non-lymphoma cancer 1-3 liver lesions measurable on CT/MRI or PET/CT performed within 6 weeks prior to study entry Liver metastases measuring \<5cm Life expectancy \>6 months Disease outside the liver is allowed Age ≥ 18 ECOG Performance Scale = 0-1 Adequate bone marrow function, defined as follows: * Absolute neutrophil count (ANC) ≥ 1,000 cells/mm3 based upon CBC/differential obtained within 4 weeks prior to registration on study * Platelets ≥ 60,000 cell/mm3 based upon CBC/differential obtained within 4 weeks prior to registration on study * Hemoglobin ≥ 8.0 g/dl based upon CBC/differential obtained within 4 weeks prior to registration on study (Note: the use of transfusion or other intervention to achieve Hgb ≥ 8.0 is acceptable.) Adequate kidney function (serum creatinine \<2mg/dL) based on chemistry panel obtained within 4 weeks prior to registration on study Adequate liver function, defined as total bilirubin \<5 mg/dL, serum albumin \>2.0g/dL, serum levels of liver enzymes \< 5 times the upper limit of normal, and INR \< 1.5 Previous liver resection or ablative therapy is permitted Chemotherapy and/or targeted agent therapy must be completed at least 2 weeks prior to radiation and started at least 14 days after completion of SBPT Women of childbearing potential and male participants must practice adequate contraception Patient must sign study specific informed consent prior to study entry Pretreatment evaluations required for eligibility include: * A complete history and general physical examination * For women of childbearing potential, a serum or urine pregnancy test must be performed within 72 hours prior to registration * INR, total bilirubin, albumin, alkaline phosphatase, ALT, AST within 4 weeks prior to study entry Exclusion Criteria: Prior invasive malignancy other than liver met primary (except non-melanomatous skin cancer) unless disease free for \> 3years Prior radiotherapy that would results in overlap of radiation fields Prior radiotherapy to the liver Severe, active co-morbidity that may impact survival CNS metastases Tense ascites requiring frequent paracentesis Active liver infection Pregnancy, nursing women, or women of child bearing potential, and men who are sexually active and not willing/able to use medically acceptable forms of contraception Metastases location within 2cm of GI tract \-