Hypofractionated ablative radiation therapy for hepatocellular carcinoma: practical considerations and review of the literature

Abstract

This article is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. How to cite this article: Reyngold M, Koay EJ, Crane CH. Hypofractionated ablative radiation therapy for hepatocellular carcinoma: practical considerations and review of the literature. Hepatoma Res 2018;4:49. http://dx. Abstract Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. The prognosis for patients who present with inoperable primary liver tumors is poor with median survival times of 12 months or less. Tumor-related liver failure is a common cause of mortality, underscoring the importance of local control. Recent advancements in external beam radiation therapy delivery techniques have enabled dose escalation that in turn has significantly improved local control and has allowed radiation therapy to emerge as an effective modality in this setting. In this review, we outline the critical practical aspects of treating liver tumors with radiation including choice of fractionation, motion management, image guidance and use of intensity-modulated radiation therapy vs. proton beam therapy. We review our approach to ablative radiation therapy for HCC with consideration of underlying cirrhosis and provide a brief overview of the current literature.