Carbon-Ion Radiotherapy for Hepatocellular Carcinoma: Current Status and Future Prospects: A Narrative Review

Area of Science:

• Oncology
• Radiation Oncology
• Hepatology

Background:

• Hepatocellular carcinoma (HCC) is a radiosensitive malignancy.
• External beam radiation therapies are underutilized in current HCC treatment guidelines.
• Carbon-ion radiotherapy (C-ion RT) is an advanced external beam therapy.

Purpose of the Study:

• To review the efficacy and safety of carbon-ion radiotherapy (C-ion RT) for hepatocellular carcinoma (HCC).
• To highlight C-ion RT as a therapeutic option for HCC.
• To discuss indications and outcomes of C-ion RT in HCC management.

Main Methods:

• Narrative review of existing literature on C-ion RT for HCC.
• Analysis of patient tolerance, indications, and adverse events.
• Evaluation of local control and survival rates.

Main Results:

• C-ion RT is well-tolerated in elderly and sarcopenic patients with HCC.
• Single HCCs >30 mm in Child-Pugh A/B or ALBI 1/2 patients show excellent outcomes.
• 5-year local control and survival rates are high with minimal adverse events like radiation-induced liver damage.
• Advanced HCC with portal vein tumor thrombus may benefit in selected cases.

Conclusions:

• Carbon-ion radiotherapy (C-ion RT) is a safe and effective treatment for HCC.
• C-ion RT offers excellent local control and survival rates for larger HCCs.
• C-ion RT represents a promising therapeutic advancement for HCC management.