Technical advances in external radiotherapy for hepatocellular carcinoma

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Hepatocellular carcinoma (HCC) treatment has evolved with advancements in radiotherapy.
• Early adoption of 3-dimensional conformal radiotherapy paved the way for more sophisticated techniques.

Purpose of the Study:

• To review the advancements in radiotherapy for hepatocellular carcinoma (HCC).
• To highlight the efficacy and precision of modern radiotherapy techniques in HCC management.

Main Methods:

• Review of advanced radiotherapy modalities including intensity-modulated radiotherapy (IMRT), stereotactic ablative body radiotherapy (SABR), and charged particle therapy.
• Discussion of the role of advanced imaging in radiotherapy planning and delivery for HCC.
• Analysis of reported local control rates and toxicity profiles associated with these techniques.

Main Results:

• IMRT allows dose escalation while sparing normal tissues, beneficial for large or critically located HCC tumors.
• SABR achieves high local control rates (84%-100%) for small HCCs using hypofractionated high-dose radiation.
• Advanced techniques enable high-dose radiotherapy for various stages of HCC with manageable toxicities.

Conclusions:

• Modern radiotherapy techniques offer precise and effective treatment options for hepatocellular carcinoma.
• The lack of predictive tools for treatment response and recurrence necessitates future research focused on patient selection for radiotherapy.