The Current Role of Stereotactic Body Radiation Therapy (SBRT) in Hepatocellular Carcinoma (HCC)

The role of stereotactic body radiotherapy (SBRT), which can deliver high radiation doses to focal tumors, has greatly increased in not only early-stage hepatocellular carcinoma (HCC), but also in portal vein or inferior vena cava thrombi, thus expanding this therapy to pre-transplantation and the t...

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Bibliographic Details
Published in:Cancers 2022-09, Vol.14 (18), p.4383
Main Authors: Kimura, Tomoki, Fujiwara, Toshiki, Kameoka, Tsubasa, Adachi, Yoshinori, Kariya, Shinji
Format: Article
Language:English
Subjects:
Cancer therapies
Dosimetry
Hepatitis B
Hepatitis C
Hepatocellular carcinoma
Immune checkpoint inhibitors
Liver cancer
Liver cirrhosis
Mortality
Patients
Portal vein
Radiation therapy
Radiofrequency ablation
Review
Thrombosis
Transplantation
Tumors
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Summary:The role of stereotactic body radiotherapy (SBRT), which can deliver high radiation doses to focal tumors, has greatly increased in not only early-stage hepatocellular carcinoma (HCC), but also in portal vein or inferior vena cava thrombi, thus expanding this therapy to pre-transplantation and the treatment of oligometastases from HCC in combination with immune checkpoint inhibitors (ICI). In early-stage HCC, many promising prospective results of SBRT have been reported, although SBRT is not usually indicated as a first treatment potion in localized HCC according to several guidelines. In the treatment of portal vein or inferior vena cava tumor thrombi, several reports using various dose-fraction schedules have shown relatively good response rates with low toxicities and improved survival due to the rapid advancements in systemic therapy. Although SBRT is regarded as a substitute therapy when conventional bridging therapies to transplantation, such as transarterial chemoembolization (TACE) and radiofrequency ablation (RFA), are not applicable or fail in controlling tumors, SBRT may offer advantages in patients with borderline liver function who may not tolerate TACE or RFA, according to several reports. For oligometastases, the combination of SBRT with ICI could potentially induce an abscopal effect in patients with HCC, which is expected to provide the rationale for SBRT in the treatment of oligometastatic disease in the near future.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14184383