Leaflet manual of external beam radiation therapy for hepatocellular carcinoma: a review of the indications, evidences, and clinical trials.

Rim, Chai Hong; Yoon, Won Sup
OncoTargets and therapy
2018NA ; 11 ( 5 ) :2865-2874.
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Rim, Chai Hong - Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, Republic of Korea.
Yoon, Won Sup - Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, Republic of Korea.
ABSTRACT
The use of external beam radiation therapy (EBRT) in the treatment of hepatocellular carcinoma (HCC), which was rarely performed due to liver toxicity with a previous technique, has increased. Palliation of portal vein thrombosis, supplementation for insufficient transarterial chemoembolization, and provision of new curative opportunities using stereotactic body radiotherapy are the potential indications for use of EBRT. The mechanism of EBRT treatment, with its radiobiological and physical perspectives, differs from those of conventional medical treatment or surgery. Therefore, understanding the effects of EBRT may be unfamiliar to physicians other than radiation oncologists, especially in the field of HCC, where EBRT has recently begun to be applied. The first objective of this review was to concisely explain the indications for use of EBRT for HCC for all physicians treating HCC. Therefore, this review focuses on the therapeutic outcomes rather than the detailed biological and physical background. We also reviewed recent clinical trials that may extend the indications for use of EBRT. Finally, we reviewed the current clinical practice guidelines for the treatment of HCC and discuss the current recommendations and future perspectives.
keyword
clinical trials; external beam radiotherapy; guidelines; hepatocellular carcinoma; liver neoplasm; sorafenib; stereotactic body radiotherapy
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For use of EBRT application; combined TACE and EBRT may possibly be indicated for HCC with major vascular invasion, which is currently categorized as BCLC-C, with sorafenib as the recommended treatment.
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DOI
10.2147/OTT.S164651
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ICD 03
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