***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To evaluate quality of life ( QoL ) , an important outcome owing to poor long-term survival , after stereotactic body radiation therapy ( SBRT ) to the liver . METHODS AND MATERIAL S Patients ( n=222 ) with hepatocellular carcinoma ( HCC ) , liver metastases , or intrahepatic cholangiocarcinoma and Child-Pugh A liver function received 24 - 60 Gy of 6-fraction image-guided SBRT . Prospect i ve QoL assessment was completed with the European Organization for Research and Treatment of Cancer Quality of Life Question naire Core-30 ( QLQ-C30 ) and /or Functional Assessment of Cancer Therapy-Hepatobiliary ( FACT-Hep , version 4 ) question naires at baseline and 1 , 3 , 6 , and 12 months after treatment . Ten HCC patients with Child-Pugh B liver function were also treated . RESULTS The QLQ-C30 was available for 205 patients , and 196 completed the FACT-Hep . No difference in baseline QoL ( P = .17 ) or overall survival ( P = .088 ) was seen between the HCC , liver metastases , and intrahepatic cholangiocarcinoma patients . Appetite loss and fatigue measured by the QLQ-C30 clinical ly and statistically worsened by 1 month after treatment but recovered by 3 months . At 3 and 12 months after treatment , respectively , the FACT-Hep score had improved relative to baseline in 13%/19 % , worsened in 36%/27 % , and remained stable in 51%/54 % . Using the QLQ-C30 Global Health score , QoL improved in 16%/23 % , worsened in 34%/39 % , and remained stable in 50%/38 % at 3 and 12 months , respectively . Median survival was 17.0 months ( 95 % confidence interval [ CI ] 12.3 - 19.8 months ) . Higher baseline scores on both FACT-Hep and QLQ-C30 Global Health were associated with improved survival . Hazard ratios for death , per 10-unit decrease in QoL , were 0.90 ( 95 % CI 0.83 - 0.98 ; P = .001 ) and 0.88 ( 95 % CI 0.82 - 0.95 ; P = .001 ) , respectively . Tumor size was inversely correlated with survival . CONCLUSIONS Liver SBRT temporarily worsens appetite and fatigue , but not overall QoL.  Stereotactic body radiation therapy is well tolerated and warrants comparison against other liver-directed therapies PURPOSE We performed a Phase I dose-escalation study to explore the feasibility and safety of treating primary and metastatic liver tumors with single-fraction stereotactic body radiotherapy ( SBRT ) . METHODS AND MATERIAL S Between February 2004 and February 2008 , 26 patients were treated for 40 identifiable lesions . Nineteen patients had hepatic metastases , 5 had intrahepatic cholangiocarcinomas , and 2 had recurrent hepatocellular carcinomas . The prescribed radiation dose was escalated from 18 to 30 Gy at 4-Gy increments with a planned maximum dose of 30 Gy . Cumulative incidence functions accounted for competing risks to estimate local failure ( LF ) incidence over time under the competing risk of death . RESULTS All patients tolerated the single-fraction SBRT well without developing a dose-limiting toxicity . Nine acute Grade 1 toxicities , one acute Grade 2 toxicity , and two late Grade 2 gastrointestinal toxicities were observed . After a median of 17 months follow-up ( range , 2 - 55 months ) , the cumulative risk of LF at 12 months was 23 % . Fifteen patients have died : 11 treated for liver metastases and 4 with primary liver tumors died . The median survival was 28.6 months , and the 2-year actuarial overall survival was 50.4 % . CONCLUSIONS It is feasible and safe to deliver single-fraction , high-dose SBRT to primary or metastatic liver malignancies measuring ≤5 cm . Moreover , single-fraction SBRT for liver lesions demonstrated promising local tumor control with minimal acute and long-term toxicity . Single-fraction SBRT appears to be a viable nonsurgical option , but further studies are warranted to evaluate both control rates and impact on quality of life BACKGROUND & AIMS Quality of life ( QoL ) is an important aspect of any palliative treatment . However , few data are available from studies comparing how embolotherapy affects QoL for patients with hepatocellular carcinoma ( HCC ) . We performed a health-related QoL study in patients with HCC treated by transarterial chemoembolization ( TACE ) or (90)Y radioembolization .  METHODS We performed a prospect i ve study of patients undergoing (90)Y radioembolization ( n = 29 ) or TACE ( n = 27 ) for HCC . We assessed patients before treatment and 2 and 4 weeks after treatment using the Functional Assessment of Cancer Therapy-Hepatobiliary ( FACT-Hep ) survey . We compared differences in health-related QoL between the treatment groups using linear regression repeated- measures analysis . RESULTS At baseline , the groups had comparable baseline Child-Pugh class and performance statuses , although patients undergoing TACE had lower tumor burdens ( P = .018 ) and less-advanced disease , based on United Network for Organ Sharing and Barcelona stage ( P = .03 and P = .02 , respectively ) , permitting injections at segmental arteries ( P < .0001 ) . There were no significant differences between groups in overall FACT-Hep health-related QoL scores ( P = .055 , effect size [ ES ] , .54 ) , owing to a limited sample size . Despite the more advanced disease of patients who received (90)Y radioembolization , they had a significantly better QoL , based on social well being ( P = .019 ; ES , .65 ) , functional well-being ( P = .031 ; ES , .60 ) , and embolotherapy-specific scores ( P = .018 ; ES , .67 ) . They also had a trend toward better overall QoL ( P = .055 ; ES , .54 ) and higher Trial Outcome Index ( P = .05 ; ES , .56 ) and FACT-Hep scores ( P = .071 ; ES , .52 ) . CONCLUSIONS In a prospect i ve study , although (90)Y radioembolization was used to treat patients with more advanced disease , those who received this treatment had significant increases in several features of QoL , whereas patients who received TACE had decreases in QoL scores . However , because of the limited sample size , there was no significant difference in overall FACT-Hep health-related QoL scores . The increase was greatest in the embolotherapy-specific score . Clinical Trials.gov , number NCT00739167 
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Despite this there were few statistically significant declines in QOL scores following SABR .
All studies showed no significant QOL decline in any domain at their respective endpoints .
Conclusion Results of this systematic review demonstrate well-preserved post liver SABR QOL .