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Challenge and hope in radiotherapy of hepatocellular carcinoma

Authors
 Jinsil Seong 
Citation
 YONSEI MEDICAL JOURNAL, Vol.50(5) : 601-612, 2009 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2009
MeSH
Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/drug therapy ; Carcinoma, Hepatocellular/radiotherapy* ; Humans ; Liver/radiation effects ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/drug therapy ; Liver Neoplasms/radiotherapy* ; Neoplasm Metastasis ; Radiation Dosage ; Radiography ; Radiotherapy, Adjuvant/adverse effects ; Radiotherapy, Adjuvant/methods ; Treatment Outcome
Keywords
Radiotherapy ; hepatocellular carcinoma
Abstract
Hepatocellular carcinoma (HCC) is one of the most critical global health issues. With frequent association of viral liver disease, HCC is highly complex, harboring both cancer and chronic liver disease. The tumor stage and underlying liver function are both major determinants of the treatment selection as well as prognosis in HCC patients, thus allowing no more than a 20% chance for potentially curative therapies. Radiotherapy technology has been evolved remarkably during the past decade, and radiation can be precisely delivered, thereby permitting higher doses to the tumour and reduced doses to surrounding normal tissues. There has been increasing interest in the merits of radiotherapy in HCC over the past few years, as indicated by a Pub Med search. Radiotherapy has been used as the definitive therapy with curative intent in early stage tumours. It has been used also in combination with TACE for intermediate stage tumours. In locally advanced tumours, radiotherapy has been combined with systemic agents. Despite its efficacy, radiotherapy has not yet been incorporated into the standard management guidelines of HCC. The lack of high evidence level data, especially randomized controlled trials, has posed an obstacle in including radiotherapy into the routine treatment schema of HCC. Therefore, well-designed prospective studies are strongly recommended using developing technology for radiotherapy alone or combination therapies. Also, many issues such as the optimal dose-fractionation, intra- or extrahepatic metastasis after radiotherapy, and radiation-induced hepatic dysfunction remain to be solved. In this review, current status of radiotherapy for HCC will be discussed with regard to technical consideration and combination strategy. The limitation and future perspectives will also be discussed.
Files in This Item:
T200903711.pdf Download
DOI
10.3349/ymj.2009.50.5.601
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105319
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