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Stereotactic Body Radiotherapy: Does It Have a Role in Management of Hepatocellular Carcinoma?

Authors
 Seo Hee Choi  ;  Jinsil Seong 
Citation
 YONSEI MEDICAL JOURNAL, Vol.59(8) : 912-922, 2018 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2018
MeSH
Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/radiotherapy* ; Humans ; Liver Neoplasms/pathology ; Liver Neoplasms/radiotherapy* ; Radiosurgery/adverse effects ; Radiosurgery/methods* ; Radiotherapy Dosage ; Treatment Outcome
Keywords
Hepatocellular carcinoma ; immunotherapy ; intensity-modulated radiotherapy ; liver tumors ; radiotherapy ; stereotactic body radiotherapy
Abstract
Stereotactic body radiotherapy (SBRT) is a form of radiotherapy that delivers high doses of irradiation with high precision in a small number of fractions. However, it has not frequently been performed for the liver due to the risk of radiation-induced liver toxicity. Furthermore, liver SBRT is cumbersome because it requires accurate patient repositioning, target localization, control of breathing-related motion, and confers a toxicity risk to the small bowel. Recently, with the advancement of modern technologies including intensity-modulated RT and image-guided RT, SBRT has been shown to significantly improve local control and survival outcomes for hepatocellular carcinoma (HCC), specifically those unfit for other local therapies. While it can be used as a stand-alone treatment for those patients, it can also be applied either as an alternative or as an adjunct to other HCC therapies (e.g., transarterial chemoembolization, and radiofrequency ablation). SBRT might be an effective and safe bridging therapy for patients awaiting liver transplantation. Furthermore, in recent studies, SBRT has been shown to have a potential role as an immunostimulator, supporting the novel combination strategy of immunoradiotherapy for HCC. In this review, the role of SBRT with some technical issues is discussed. In addition, future implications of SBRT as an immunostimulator are considered.
Files in This Item:
T201802815.pdf Download
DOI
10.3349/ymj.2018.59.8.912
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/22282913/165206
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