Clinical Research Directory

Inclusion Criteria: * Primary hepatobiliary cancer confirmed pathologically * Non - lymphoma liver metastases confirmed pathologically * Radiographic liver lesions most consistent with metastases, in a patient with known pathologically proven non - lymphoma cancer and a previously negative CT or MRI of the liver * Hepatocellular carcinoma diagnosed with vascular enhancement of the lesion consistent with hepatocellular carcinoma, and with an elevated AFP, in the setting of cirrhosis or chronic hepatitis. * ≤ 5 liver lesions measurable on a contrast - enhanced liver CT or MRI performed within 90 days prior to study entry. * Primary liver lesion or liver metastases measuring ≤ 25 cm. * Extrahepatic cancer is permitted if liver involvement is judged to be life - limiting. * All intrahepatic disease must be encompassed within the radiation fields according to protocol criteria. * Patient must be judged medically or surgically unresectable * Zubrod Performance Scale = 0 - 3 * Age \> 18 * All intrahepatic disease must be amenable to TACE * Previous liver resection or ablative therapy is permitted. * Chemotherapy must be completed at least 2 weeks prior to radiation therapy or TACE, and not planned to be administered for at least 1 week (for anthracyclines at least 4 weeks) after completion of treatment. * Life expectancy \> 6 months. * 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: * A complete history and general physical examination. * CBC, INR, Total bilirubin, albumin, alkaline phosphatase, ALT, AST within 4 weeks prior to study entry. Appropriate levels are as follows: * Absolute neutrophil count (ANC) ≥ 1,500 cells / mm3 * Platelets ≥ 70,000 cells / mm3 * Hemoglobin ≥ 8.0 g / dl (Note: The use of transfusion or other intervention to achieve Hgb ≥ 8.0 g / dl is acceptable.) * Total bilirubin \< 3 mg / dL * Prothrombin time / INR \< 2 (if not on anticoagulants) * Albumin ≥ 28 g / L * AST and ALT \< 10 times ULN Exclusion Criteria: * Severe cirrhosis or liver failure defined as Child Pugh \> B7 * Primary liver tumor or liver metastasis \> 25 cm in maximal dimension. * Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields * Severe, active co-morbidity, defined as limiting the patients life to less than 6 months * Active hepatitis or clinically significant liver failure. * Pregnancy, nursing women, or women of childbearing potential, and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be teratogenic.