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Radiation Therapy for Hepatocellular Carcinoma: Clinical Data

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Radiation Therapy for Liver Tumors

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Abstract

Although there are a number of liver-directed therapies available for inoperable organ-confined hepatocellular carcinoma (HCC), there is growing literature that radiation plays an increasingly important role in the management of all stages of HCC. Radiation is a noninvasive treatment modality that can serve as bridge therapy for patients with early stage HCC who are awaiting transplant; as ablative, definitive treatment for patients with intermediate-stage disease; and for palliation in advanced disease. The promising results of early experiences with fractionated, conformal radiotherapy have led to interest in dose-escalation through stereotactic body radiotherapy (SBRT) and charged particle therapy. There is also growing interest in combining these various radiation approaches with other regional and systemic treatment modalities for improved efficacy. This chapter provides a summary of the clinical data for radiation therapy, including fractionated external beam radiation therapy (EBRT), SBRT, charged particle therapy, brachytherapy, and radioembolization, and discusses results of radiation in various clinical scenarios.

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Abbreviations

BCLC:

Barcelona clinic liver cancer

BED:

Biological effective dose

EBRT:

External beam radiotherapy

FACT-Hep:

Functional assessment of cancer therapy—Hepatobiliary cancer

FFLP:

Freedom from local progression

iBR:

Interstitial brachytherapy

HCC:

Hepatocellular carcinoma

HDR:

High-dose-rate

GI:

Gastrointestinal

MTD:

Maximum tolerated dose

NTCP:

Normal tissue complication probability

PMH:

Princess Margaret hospital

PVT:

Portal vein thrombus

TARE:

Transarterial radioembolization

RBE:

Relative biological effectiveness

REILD:

TARE-induced liver disease

RFA:

Radiofrequency ablation

RILD:

Radiation induced liver disease

RT:

Radiotherapy

SBRT:

Stereotactic body radiotherapy

SABR:

Stereotactic ablative radiotherapy

TACE:

Transarterial chemoembolization

TTP:

Time to progression

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Authors and Affiliations

  1. Department of Radiation Oncology, Stanford Healthcare, 875 Blake Wilbur Drive, MC 5847, Stanford, CA, 94305-5847, USA

    Erqi L. Pollom MD, Yushen Qian MD & Daniel T. Chang MD

  2. Stanford University School of Medicine, 566 Arguello Way, Stanford, CA, 94305, USA

    Julie L. Koenig BS

  3. Radiation Oncology, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Albert C. Koong MD, PhD

Authors
  1. Erqi L. Pollom MD
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  2. Yushen Qian MD
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  3. Julie L. Koenig BS
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  4. Albert C. Koong MD, PhD
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  5. Daniel T. Chang MD
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Corresponding author

Correspondence to Daniel T. Chang MD .

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Editors and Affiliations

  1. Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA

    Jeffrey Meyer

  2. Department of Radiation Oncology, University of Colorado Comprehensive Cancer Center, Aurora, Colorado, USA

    Tracey Schefter

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Pollom, E.L., Qian, Y., Koenig, J.L., Koong, A.C., Chang, D.T. (2017). Radiation Therapy for Hepatocellular Carcinoma: Clinical Data. In: Meyer, J., Schefter, T. (eds) Radiation Therapy for Liver Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-54531-8_14

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