The role of external beam radiotherapy in the treatment of hepatocellular cancer.
Journal Article (Journal Article;Review)
Hepatocellular carcinoma (HCC) is increasing in incidence and mortality. Although the prognosis remains poor, long-term survival has improved from 3% in 1970 to an 18% 5-year survival rate today. This is likely because of the introduction of well tolerated, oral antiviral therapies for hepatitis C. Curative options for patients with HCC are often limited by underlying liver dysfunction/cirrhosis and medical comorbidities. Less than one-third of patients are candidates for surgery, which is the current gold standard for cure. Nonsurgical treatments include embolotherapies, percutaneous ablation, and ablative radiation. Technological advances in radiation delivery in the past several decades now allow for safe and effective ablative doses to the liver. Conformal techniques allow for both dose escalation to target volumes and normal tissue sparing. Multiple retrospective and prospective studies have demonstrated that hypofractionated image-guided radiation therapy, used as monotherapy or in combination with other liver-directed therapies, can provide excellent local control that is cost effective. Therefore, as the HCC treatment paradigm continues to evolve, ablative radiation treatment has moved from a palliative treatment to both a "bridge to transplant" and a definitive treatment.
Full Text
Duke Authors
- Choi, Steven Sok
- Czito, Brian Gary
- Godfrey, Devon James
- Kim, Charles Yoon
- Marin, Daniele
- Morse, Michael Aaron
- Palta, Manisha
- Stephens, Sarah Jo
- Willett, Christopher G.
Cited Authors
- Chino, F; Stephens, SJ; Choi, SS; Marin, D; Kim, CY; Morse, MA; Godfrey, DJ; Czito, BG; Willett, CG; Palta, M
Published Date
- September 1, 2018
Published In
Volume / Issue
- 124 / 17
Start / End Page
- 3476 - 3489
PubMed ID
- 29645076
Electronic International Standard Serial Number (EISSN)
- 1097-0142
Digital Object Identifier (DOI)
- 10.1002/cncr.31334
Language
- eng
Conference Location
- United States