Conclusion:
CyberKnife® radiosurgery represents an extremely precise ablative radiation technique that offers a potent new treatment alternative for patients with hepatocellular carcinoma, cholangiocarcinoma, or liver metastases. The large number of targeting angles and the target tracking capability of the CyberKnife® Synchrony® respiratory tracking feature, enables radiation conformality around the tumor volume approaching that of a surgeon’s scalpel.

CyberKnife® radiosurgical treatment is reasonable to administer as aggressive “bridge therapy” to  hepatocellular carcinoma (HCC) patients awaiting transplantation, or as potentially curative therapy to HCC patients that are not candidates for surgical removal of their HCC tumor. It is a radiobiologically ablative form of radiation against liver metastases, allowing extreme radiation dose escalation compared with standard radiation delivery systems. Used with caution and in conjunction with judicious surgical displacement of sensitive gastrointestinal tissues, it also appears appropriately directed against selected cholangiocarcinoma tumors.