Abstract
Radiation therapy for liver tumors has changed dramatically in the last few decades, from purely palliative to now potentially curative in the form of stereotactic body radiation therapy (SBRT). Recent progress with imaging suggests that prospective characterization of individual tumor subpopulations within these tumors may not only have prognostic value but also may allow personalized heterogeneous radiotherapy dosing. Improved on-board radiation treatment imaging strategies may lead to real-time adapted treatment tailored to the patient’s individual tumor and functional response. The future question is how best to optimize the power of SBRT both to ablate the local tumor and to potentially work with immune therapy agents to produce a systemic antitumor effect.