Radiation therapy for hepatocellular carcinoma

Abstract

Technologic advances have provided the means to deliver tumoricidal doses of radiation therapy (RT) to patients with unresectable hepatocellular carcinoma (HCC) while avoiding critical normal tissues, providing the opportunity to use RT for curative intent treatment of HCC. For the current report, the expanded role of external beam RT in the setting of HCC from palliation to cure was reviewed. A systematic literature search was undertaken using the MEDLINE data base and secondary references to identify peer-reviewed, English-language articles that re- control response rates ranged from 40% to 90%, and the median survival ranges from 10 months to 25 months. For patients with HCC who had portal vein thrombus, the median survival after RT to treat the thrombus and/or the hepatic tumor with or without TACE ranged from 5.3 months to 9.7 months. Although outcomes after high-dose conformal RT for liver-confined HCC were excellent, the potential survival benefit of RT should be tested in randomized controlled trials that require international collaboration.

Individualized image guided iso-NTCP based liver cancer SBRT

“…Analysis of over 200 patients with liver cancer treated with conformal hyperfractionated radiation therapy at the University of Michigan has led to a better understanding of the partial volume tolerance of the liver to radiation therapy [8]. Outcomes following conformal radiation therapy for both primary and metastatic unresectable focal liver cancers are encouraging [1,3,18,19].…”

Inter‐ and intrafractional setup errors and baseline shifts of fiducial markers in patients with liver tumors receiving free‐breathing postoperative radiation analyzed by cone‐beam computed tomography

“…Technological advances in the planning and delivery of radiotherapy (RT), such as intensity‐modulated radiotherapy (IMRT) or three‐dimensional conformal radiotherapy (3D CRT) combined with image‐guided radiotherapy (IGRT), have enabled dose escalation in RT delivered to patients with unresectable liver tumors, while sparing the adjacent organs and normal liver. Nowadays, radiotherapy plays an important role in the treatment of unresectable or inoperable HCC 3 , 4 . Combined with transcatheter arterial chemoembolization (TACE), which is the first choice for patients with unresectable HCC, radiotherapy can improve the survival of the unresectable HCC patients 5 , 6 , 7 .…”

Analysis of the advantage of individual PTVs defined on axial 3D CT and 4D CT images for liver cancer

“…With the use of three‐dimensional radiotherapy (3D CRT) and image‐guided radiotherapy (IGRT), radiotherapy has been accepted for treatment of liver cancer 1 , 3 . However, the conventional 3D CRT for liver cancer is generally based on axial three‐dimensional CT (3D CT) scanning.…”