Background:~Pilot study to assess feasibility for combining treatment modalities that should be synergistic (radiation and thermal ablation).~Thermal ablation with Radiofrequency Ablation (RFA) and microwave ablation (MWA) are standard treatments for focal neoplasms in the liver.~High volume or scattered locations of tumor burden results in inability to successfully use this technology for a large proportion of patients with hepatic neoplasms.~Methods to enhance treatment volumes could be advantageous in potentially increasing the indications for thermal ablation or the number of patients benefitting from local ablation.~Primary objective:~To determine the safety of combining 2 standard therapies (thermal ablation and external beam radiation therapy) for liver neoplasms up to 10 cm diameter.~Eligibility:~Patients greater than 18 years of age with pathologically proven unresectable primary or metastatic hepatic neoplasms~Patients whose extent of hepatic neoplasms represents approximately less than 60% of total liver volume AND whose extrahepatic metastatic disease is determined to be minimal~ECOG performance status of less than or equal to 2 and a life expectancy of more than 3 months~Patients with a history of chemotherapy, radiation therapy to liver, or biological therapy must have had last dose/ treatment for at least 14 days prior to starting study treatments.~Patients must not have an acute, critical illness~Design:~Patients will undergo external beam radiation as well as thermal ablation according to standard operating procedures of the NCI and NIH CC.~Patients will be monitored using the standard imaging studies when clinically warranted.~Patients may be treated with a second (or more) thermal ablation procedure ALONE if it is deemed beneficial for the patient by the investigator.~The sample size will be 10 evaluable patients
Background:~Pilot study to assess feasibility for combining treatment modalities that should be synergistic (radiation and thermal ablation).~Thermal ablation with Radiofrequency Ablation (RFA) and microwave ablation (MWA) are standard treatments for focal neoplasms in the liver.~High volume or scattered locations of tumor burden results in inability to successfully use this technology for a large proportion of patients with hepatic neoplasms.~Methods to enhance treatment volumes could be advantageous in potentially increasing the indications for thermal ablation or the number of patients benefitting from local ablation.~Primary objective:~To determine the safety of combining 2 standard therapies (thermal ablation and external beam radiation therapy) for liver neoplasms up to 10 cm diameter.~Eligibility:~Patients greater than 18 years of age with pathologically proven unresectable primary or metastatic hepatic neoplasms~Patients whose extent of hepatic metastases represents approximately less than 60% of total liver volume AND whose extrahepatic metastatic disease is determined to be minimal~ECOG performance status of less than or equal to 2 and a life expectancy of more than 3 months~Patients with a history of chemotherapy, radiation therapy, or biological therapy for at least 4 weeks prior to starting study treatments, and 4 weeks after treatments Patients must not have an acute, critical illness~If clinical or imaging evidence for cirrhosis present, then Bilirubin must be less than 3 mg/dl and Child-Pugh Classification A, (Class B & C are excluded)~Design:~Patients will undergo external beam radiation as well as thermal ablation according to standard operating procedures of the NCI and NIH CC.~Patients will be monitored using the standard imaging studies when clinically warranted.~Patients may be treated with a second (or more) thermal ablation procedure ALONE if it is deemed beneficial for the patient by the investigator.~The sample size will be 10 evaluable patients