Advances in external beam radiation for hepatocellular carcinoma, stereotactic body radiation therapy (SBRT) and particle therapy

Abstract

Hepatocellular carcinoma (HCC) represents a leading cause of cancer-related mortality globally. Due to frequently complex disease presentation and comorbid underlying cirrhosis, many patients are not ideal candidates for surgical resection, transplantation, or other local ablative treatments. External beam radiation therapy (EBRT) has emerged as a promising alternative. EBRT has gained prominence due to advancements in targeting and treatment delivery technology. Advanced modalities such as intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), stereotactic body radiation therapy (SBRT), and proton beam therapy (PBT) have dramatically improved the precision of radiation delivery, resulting in a far more favorable therapeutic ratio. Here we cover the evolution of current practice and future prospects of EBRT in treating HCC, emphasizing the enhanced efficacy and reduced toxicity provided by these advanced technologies, and improved integration with other loco-regional and systemic therapies in reviewing the current indications for treatment.

Keywords

Radiation / external / beam radiation / stereotactic body radiation / SBRT / SABR / proton / hepatocellular

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