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Related Experiment Video

Updated: Dec 27, 2025

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
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Stereotactic Body Radiotherapy for Large Unresectable Hepatocellular Carcinomas - A Single Institution Phase II

L Beaton1, E M Dunne1, R Yeung1

  • 1Department of Radiation Oncology, BC Cancer - Vancouver Center, Vancouver, British Columbia, Canada.

Clinical Oncology (Royal College of Radiologists (Great Britain))
|February 26, 2020
PubMed
Summary

Stereotactic body radiotherapy (SBRT) offers excellent local control for large, unresectable hepatocellular carcinomas (HCC). This liver SBRT treatment showed promising survival rates and manageable toxicities in patients with advanced liver cancer.

Keywords:
Hepatocellular carcinomastereotactic body radiotherapy (SBRT)unresectable

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Area of Science:

  • Oncology
  • Radiotherapy
  • Hepatobiliary Cancers

Background:

  • Hepatocellular carcinoma (HCC) larger than 5 cm often presents as unresectable.
  • Limited treatment options exist for patients with unresectable HCC ineligible for other therapies.
  • Child-Pugh score (CPS) ≤ B7 indicates a specific patient population with compromised liver function.

Purpose of the Study:

  • To assess the safety and efficacy of liver stereotactic body radiotherapy (SBRT) for unresectable HCCs >5 cm.
  • To evaluate local control, overall survival, and toxicity profiles.
  • To determine the impact on quality of life in this patient cohort.

Main Methods:

  • A single-institution phase II study enrolled 13 patients with unresectable HCC (>5 cm) and CPS ≤ B7.
  • Volumetric-modulated arc radiotherapy (VMAT) was used to deliver SBRT, with a median dose of 45 Gy in five fractions.
  • Radiological response was assessed using modified Response Evaluation Criteria in Solid Tumours (mRECIST), and toxicities were graded per Common Terminology Criteria for Adverse Events (CTCAE) v4.

Main Results:

  • A 1-year local control rate of 92% was achieved in 16 treated hepatomas (median size 7.5 cm).
  • Median overall survival was 17.7 months, with a 1-year survival rate of 62%.
  • Grade 3 acute toxicities occurred in 7 patients (54%), primarily hematological; quality of life remained stable or improved in over 50% of patients at 3 months.

Conclusions:

  • Liver SBRT demonstrates excellent local control and acceptable toxicity for unresectable, large HCC tumors.
  • Regional recurrence was the primary mode of treatment failure, suggesting a need for systemic or regional therapies.
  • Further research is recommended to explore SBRT combined with other modalities to enhance disease control in the liver.