Stereotactic radiotherapy for hepatocellular carcinoma: Expanding the multidisciplinary armamentarium

Mihir D. Shanker, Howard Y. Liu, Yoo Young Lee, Katherine A. Stuart, Elizabeth E. Powell, Alan Wigg, David I. Pryor

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)

Abstract

Hepatocellular carcinoma (HCC) is the fifth most common malignancy worldwide and the third most common cause of cancer-related death. Long-term prognosis remains poor with treatment options frequently limited by advanced tumor stage, tumor location, or underlying liver dysfunction. Stereotactic ablative body radiotherapy (SABR) utilizes technological advances to deliver highly precise, tumoricidal doses of radiation. There is an emerging body of literature on SABR in HCC demonstrating high rates of local control in the order of 80–90% at 3 years. SABR is associated with a low risk of radiation-induced liver disease or decompensation in appropriately selected HCC patients with compensated liver function and is now being incorporated into guidelines as an additional treatment option. This review outlines the emerging role of SABR in the multidisciplinary management of HCC and summarizes the current evidence for its use as an alternative ablative option for early-stage disease, as a bridge to transplant, and as palliation for advanced-stage disease. We outline specific considerations regarding patient selection, toxicities, and response assessment. Finally, we compare current international guidelines and recommendations for the use of SABR and summarize ongoing studies.

Original languageEnglish
Pages (from-to)873-884
Number of pages12
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume36
Issue number4
DOIs
Publication statusPublished - Apr 2021
Externally publishedYes

Keywords

  • Cancer: biology, diagnosis, and therapy
  • Hepatocellular carcinoma, clinical
  • Hepatocellular carcinoma, treatment
  • Neoplasia

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