The management of primary liver malignancy and metastasis is complex, converversal and involving many specialties such as radiation oncologist, interventional radiologist, oncologic surgeon, liver transplant, hepatologist, medical oncologist. Radiation therapy has re-gained the its position in this arena with the emerging data for stereotactic body radiotherapy, particle beam therapy, and radioembolization with Yttrium-90 microspheres. There are other competing local treatment modalities such as surgery, transplant, Drug-eluting beads, TACE, and Radiofrequency ablation, The clinical benefit to be gained from yttrium-90 microsphere therapy for metastases is by rational combination with radiosensitizing systemic chemotherapy: how Yttrium-90 microsphere therapy should be optimally combined with fluoropyrimidine-, oxaliplatin- and irinotecan-based regimes, based on radiobiological principles, knowledge of DNA damage repair and using patient cases as examples; The panel will also expore how combination with yttrium-90 microsphere therapy is being performed with agents such as cetuximab and vasoactive agents in clinical trials, including functional imaging studies and predictive tissue biomarkers. The guidelines for clinical indication, exclusion, and integration of multi-modality treatment are not well defined. There are many areas of controversals in the management. There are several practical issues in implementing the comprehensive treatment programs. The goal of this scientific panel is to educate and update the radiation oncology physicians, residents, physicist/dosimetrists, and nurses the practical aspects of this disease. At the conclusion of this activity, the learner will be able to do the following: 1. Identify the roles of each clinical specialties and their indications in the management of liver malignancy and metastasis. 2. Illustrate the lack of training physicians in implementing certain types of treatments (Y-90 microspheres, SBRT, etc.). 3. Identify issues in insurance reimbursement .