Open AccessCurrent Understanding of Ablative Radiation Therapy in Hepatocellular Carcinoma
Author(s) -
Ashwathy Susan Mathew,
Laura Dawson
Publication year - 2021
Publication title -
journal of hepatocellular carcinoma
Language(s) - English
Resource type - Journals
ISSN - 2253-5969
DOI - 10.2147/jhc.s284403
Subject(s) - ablative case , medicine , hepatocellular carcinoma , sabr volatility model , radiation therapy , radiofrequency ablation , radiology , radiosurgery , ablation , oncology , volatility (finance) , stochastic volatility , financial economics , economics
The role of ablative stereotactic body radiotherapy (SBRT) in hepatocellular carcinoma (HCC) has been evolving over the last few decades. SBRT has mostly been used in early stages of HCC, including few (≤ 3 in number) tumors, small tumours (< 3 cm in size), as well as larger tumours which are ineligible for other ablative modalities, mostly without vascular invasion. In early stage HCC, SBRT is used as a definitive treatment with curative intent or with intent to bridge to liver transplant. Retrospective and prospective institutional series document a high rate of local control (68-95% at 3 years) following SBRT. This coupled with a low risk of toxicity makes this non-invasive ablative treatment an attractive option for patients who are ineligible for other ablative treatments. Small randomized studies of ablative radiation have also shown non-inferiority of radiation as compared to radiofrequency ablation (RFA). Currently, SBRT is widely available as a safe and effective liver directed therapy, although there is a need for more studies providing higher level evidence. This review gives a brief overview of SBRT and the evidence for its use in HCC patients with ablative intent.