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过去的几十年，在肝转移癌的治疗方面，放疗已经越来越多的应用于临床。对于局部肝转移癌，临床上往往采取加大剂量已提高局部控制率，以期提高患者生产期。但是，对于有症状的广泛性肝转移患者则给以全肝低剂量照射。放疗已成为不适合手术或化疗等方式的肝转移癌患者的有效治疗手段。放疗靶区勾画及放疗技术进步更好的保护了高剂量靶区周围的正常肝脏组织，使得提高靶区放疗剂量的手段很好的应用于临床。关于肝转移癌的适形与立体定向放疗治疗的提高局控率及生存期的临床研究不断出现。本文就局部肝转移的根治放疗与全肝的姑息放疗临床数据做相关综述，认为放疗在肝转移癌的治疗中是安全，有效的。但是，肝转移癌的临床随机试验研究仍较匮乏。

英文摘要:

Over the past decades, there has been an increasing use of radiotherapy (RT) for the treatment of liver metastases. Most often, ablative doses are delivered to focal liver metastases with the goal of local control and ultimately improving survival. In contrast, low-dose whole-liver RT may be used for the palliation of symptomatic diffuse metastases. RT is a treatment option that can be offered to patients unsuitable for surgery or other ablative therapies. Technological advances in RT planning and delivery have made it possible to administer high doses conformally around focal liver metastases effectively. The clinical experience in conformal RT and stereotactic body RT for liver metastases is emerging, with trials demonstrating excellent local control and occasional long-term survivors. This review examines the available clinical data for both approaches. The review found that RT is effective both for local ablation of focal liver metastases and for palliation of patients with symptomatic liver metastases. However, there is a lack of a high level of evidence from randomized clinical trials in this area.

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