Conformal radiotherapy for hepatocellular carcinoma

R. V. Tse, Chandan Guha, L. A. Dawson

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations

Abstract

Technical advancements in radiation therapy (RT) have facilitated the safe delivery of conformal, dose-escalated radiation to a wide spectrum of hepatocellular carcinoma (HCC) patients. A variety of doses and RT fractionation schemes have been used, and RT has been used in combination with transarterial chemoembolization (TACE). Compared to untreated historical controls or those treated with TACE alone, outcomes following RT alone or TACE and RT are better. Despite advances in RT delivery, liver toxicity following RT remains a dose-limiting factor, and investigations to better understand the pathophysiology of RT-induced liver toxicity are warranted. For most tumors, RT can provide sustained local control. However, HCC tends to recur within the liver away from the irradiated volume, providing rationale for combining RT with systemic or regional therapies. There is a particular interest in combining RT with anti-VEGF-targeted agents for their independent activity in HCC as well as their radiation sensitization properties. Randomized trials of RT are warranted.

Original languageEnglish (US)
Pages (from-to)113-123
Number of pages11
JournalCritical Reviews in Oncology/Hematology
Volume67
Issue number2
DOIs
StatePublished - Aug 1 2008

Keywords

  • Conformal radiotherapy
  • Hepatocellular carcinoma
  • Proton therapy
  • Radiation-induced liver disease (RILD)
  • Radiotherapy
  • Stereotactic radiotherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology

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