Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Sep 8;14(18):4383.
doi: 10.3390/cancers14184383.

The Current Role of Stereotactic Body Radiation Therapy (SBRT) in Hepatocellular Carcinoma (HCC)

Tomoki Kimura  1 , Toshiki Fujiwara  1 , Tsubasa Kameoka  1 , Yoshinori Adachi  1   2 , Shinji Kariya  1
Affiliations
Review

The Current Role of Stereotactic Body Radiation Therapy (SBRT) in Hepatocellular Carcinoma (HCC)

Tomoki Kimura et al. Cancers (Basel). .

Abstract

The role of stereotactic body radiotherapy (SBRT), which can deliver high radiation doses to focal tumors, has greatly increased in not only early-stage hepatocellular carcinoma (HCC), but also in portal vein or inferior vena cava thrombi, thus expanding this therapy to pre-transplantation and the treatment of oligometastases from HCC in combination with immune checkpoint inhibitors (ICI). In early-stage HCC, many promising prospective results of SBRT have been reported, although SBRT is not usually indicated as a first treatment potion in localized HCC according to several guidelines. In the treatment of portal vein or inferior vena cava tumor thrombi, several reports using various dose-fraction schedules have shown relatively good response rates with low toxicities and improved survival due to the rapid advancements in systemic therapy. Although SBRT is regarded as a substitute therapy when conventional bridging therapies to transplantation, such as transarterial chemoembolization (TACE) and radiofrequency ablation (RFA), are not applicable or fail in controlling tumors, SBRT may offer advantages in patients with borderline liver function who may not tolerate TACE or RFA, according to several reports. For oligometastases, the combination of SBRT with ICI could potentially induce an abscopal effect in patients with HCC, which is expected to provide the rationale for SBRT in the treatment of oligometastatic disease in the near future.

Keywords: bridging therapy; hepatocellular carcinoma (HCC); inferior vena cava tumor thrombus (IVCTT); oligometastasis; portal vein tumor thrombus (PVTT); stereotactic body radiotherapy (SBRT).

PubMed Disclaimer

Conflict of interest statement

Lecture fee from AstraZeneca Co., Ltd., Educational donation from Hitachi, Ltd. (Tomoki Kimura).

Figures

Figure 1
Figure 1
A typical case of complete response at 3.5 months after the completion of SBRT. (A) Dynamic MRI appearance (arterial phase) before SBRT; the early arterial enhancement is obvious (red arrow). (B) Dynamic MRI appearance (arterial phase) after 3.5 months; the early arterial enhancement has disappeared (red arrow). (C) Dose distribution of SBRT: the prescribed dose of 40 Gy covered 95% of PTV with 125% maximum dose of 40 Gy (80% isodose) in 4 fractions.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2021;71:209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Kudo M., Izumi N., Kokudo N., Sakamoto M., Shiina S., Takayama T., Tateishi R., Nakashima O., Murakami T., Matsuyama Y., et al. Report of the 21st follow-up survey of primary liver cancer in Japan (2010–2011) Hepatol. Res. 2021;51:355–405. doi: 10.1111/hepr.13612. - DOI - PubMed
    1. Seo Y.S., Kim M.S., Yoo S.Y., Cho C.K., Choi C.W., Kim J.H., Han C.J., Park S.C., Lee B.H., Kim Y.H., et al. Preliminary result of stereotactic body radiotherapy as a local salvage treatment for inoperable hepatocellular carcinoma. J. Surg. Oncol. 2010;102:209–214. doi: 10.1002/jso.21593. - DOI - PubMed
    1. Kwon J.H., Bae S.H., Kim J.Y., Choi B.O., Jang H.S., Jang J.W., Choi J.Y., Yoon S.K., Chung K.W. Long-term effect of stereotactic body radiation therapy for primary hepatocellular carcinoma ineligible for local ablation therapy or surgical resection. Stereotactic radiotherapy for liver cancer. BMC Cancer. 2010;10:475. doi: 10.1186/1471-2407-10-475. - DOI - PMC - PubMed
    1. Sanuki N., Takeda A., Oku Y., Mizuno T., Aoki Y., Eriguchi T., Iwabuchi S., Kunieda E. Stereotactic body radiotherapy for small hepatocellular carcinoma: A retrospective outcome analysis in 185 patients. Acta Oncol. 2014;53:399–404. doi: 10.3109/0284186X.2013.820342. - DOI - PubMed

LinkOut - more resources