TY - JOUR
T1 - Conformal radiotherapy for hepatocellular carcinoma
AU - Tse, R. V.
AU - Guha, Chandan
AU - Dawson, L. A.
N1 - Funding Information:
The authors would like to acknowledge financial support from the Canadian Cancer Society, National Cancer Institute of Canada (NCIC grant 018207), the Gerry Ruby Fund (Princess Margaret Hospital), and Elekta Oncology Systems.
PY - 2008/8
Y1 - 2008/8
N2 - 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.
AB - 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.
KW - Conformal radiotherapy
KW - Hepatocellular carcinoma
KW - Proton therapy
KW - Radiation-induced liver disease (RILD)
KW - Radiotherapy
KW - Stereotactic radiotherapy
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U2 - 10.1016/j.critrevonc.2008.01.005
DO - 10.1016/j.critrevonc.2008.01.005
M3 - Review article
C2 - 18308583
AN - SCOPUS:45949100612
SN - 1040-8428
VL - 67
SP - 113
EP - 123
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
IS - 2
ER -