The introduction of innovative technical developments: the three-dimensional planning, using multileaf collimator, simulated by the intensity radiation therapy, improved methods of fixation significantly improved ability of accurate delivering and escalating of doses of ionizing radiation to the selected volume of tissues. This has changed the perception of the role of radiation therapy in the treatment of liver metastases. Foreign authors data suggest the possibility of reaching 95% local control one year after stereotactic radiotherapy, 92% - after two years (and 100% for tumors smaller than 3 cm.) with the development third or higher degree of radiation damage near in 2%. In 2011, after the technical upgrading of Blokhin Cancer center, the method of stereotactic radiosurgery (SBRS) was introduced in clinical practice for the treatment of patients with liver metastases. This method allows to create a high-dose ionizing radiation in metastatic tumor and cause the destruction of the tumor. This is a promising direction in the treatment of metastatic liver cancer significantly expanded the capabilities of the combined treatment. The article provides an overview of the literature on the treatment of liver metastases, and we publish the results of the use of stereotactic radiosurgery at thirty-five patients with liver metastases and clinical case of successful application of this method in patient with significant co-morbidity.

The article describes the stages of emergence and development of radiotherapy in management of malignancies of various locations, covering the period from the discovery of X-rays to the use of 60Co artificial isotope and development of the linear electron accelerator. Currently, radiotherapy is required for 70 % of cancer patients at some stage of tumor treatment. Improvements in radiotherapy technologies and development of new irradiation techniques made possible to solve the main task of radiotherapy, i.e. tumor destruction with minimal radiation exposure to surrounding healthy tissues, at the time being. This paper describes the radiotherapy techniques and explains in detail the differences between conventional and conformal radiotherapy. Also, preparation of patients for radiotherapy and the features of various conformal radiotherapy technologies are included.

The authors discuss changes in the equipment and technologies of radiotherapy during the past 10-15 years. These changes ensured the improvement of diagnostics and treatment of neoplasms by two other main methods, surgical and medicamental. Modifications in the combined application of radiotherapy and surgery and of radio- and pharmacotherapy are discussed.

The article describes the development of radiotherapeutic techniques in Blokhin Russian Oncological Scientific Center of Russian Academy of Medical Sciences at the end of the 20th and the beginning of the 21st centuries. Such developmental directions in radiation oncology as the development of non-conventional modes of radiation dose fractioning, the development of new radiotherapeutic techniques based on volumetric 3D dosimetric radiotherapy planning, the perfection of combined (contact plus distant) radiotherapy, the use of multidirectional radiomodifying agents, the application of radiotherapy as a part of combined and complex treatment with chemotherapy and surgery in different tumoral sensitivity to conservative treatment, are considered in the article. Immediate and long-term results achieved at the institution by the use of radiotherapy alone or as a part of combined or complex treatment in cases with certain malignant tumor localizations are described.

At the present stage of radiation oncology, treatment successes are mainly determined by improvement of multimodality therapy that utilizes benefits of each modality in individual patients. Radiotherapy is mostly empiric, as demonstrated by dose fractionation. Its significance in many situations is underestimated, which leads to unreasonably excessive irradiation or, vice versa, to its unreasonable refusal. So clinical searches for new knowledge of the actual role of radiotherapy in specific clinical situations are therefore continued. The advent of new-generation radiation therapy apparatuses opens up fresh opportunities for development of rational radiation methods by mathematically optimizing dosage fields of irradiation and creating its conformable conditions. The necessary conditions for further radiotherapy successes are continuation of research developments in rational simulation of spatial dosage distribution, in the use of radio sensibilizers and radio protectors, and in contact methods of radiotherapy and intraoperative irradiation.