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World J Gastroenterol. Mar 28, 2014; 20(12): 3100-3111
Published online Mar 28, 2014. doi: 10.3748/wjg.v20.i12.3100
Role of stereotactic body radiation therapy for hepatocellular carcinoma
Naoko Sanuki, Atsuya Takeda, Etsuo Kunieda
Naoko Sanuki, Atsuya Takeda, Radiation Oncology Center, Ofuna Chuo Hospital, Kanagawa 247-0056, Japan
Etsuo Kunieda, Department of Radiation Oncology, Tokai University, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
Author contributions: Sanuki N contributed to the manuscript idea, literature search, manuscript writing and final revision of the article; Takeda A contributed to the manuscript idea and the final revision of the article; Kunieda E contributed to the final revision of the article.
Correspondence to: Naoko Sanuki, MD, Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24, Ofuna, Kamakura, Kanagawa 247-0056, Japan. nao5-tky@umin.org
Telephone: +81-467-452111 Fax: +81-467-483197
Received: September 28, 2013
Revised: December 20, 2013
Accepted: January 8, 2014
Published online: March 28, 2014
Abstract

The integration of new technologies has raised an interest in liver tumor radiotherapy, with literature evolving to support its efficacy. These advances, particularly stereotactic body radiation therapy (SBRT), have been critical in improving local control or potential cure in liver lesions not amenable to first-line surgical resection or radiofrequency ablation. Active investigation of SBRT, particularly for hepatocellular carcinoma (HCC), has recently started, yielding promising local control rates. In addition, data suggest a possibility that SBRT can be an alternative option for HCC unfit for other local therapies. However, information on optimal treatment indications, doses, and methods remains limited. In HCC, significant differences in patient characteristics and treatment availability exist by country. In addition, the prognosis of HCC is greatly influenced by underlying liver dysfunction and treatment itself in addition to tumor stage. Since they are closely linked to treatment approach, it is important to understand these differences in interpreting outcomes from various reports. Further studies are required to validate and maximize the efficacy of SBRT by a large, multi-institutional setting.

Keywords: Hepatocellular carcinoma, Liver cirrhosis, Liver neoplasms, Radiation therapy, Stereotactic body radiation therapy

Core tip: The integration of new technologies has raised an interest in radiotherapy for hepatocellular carcinoma (HCC), with literature evolving to support its efficacy. These advances, particularly stereotactic body radiation therapy (SBRT), have been critical in improving local control or potential cure in liver lesions not amenable to first-line surgical resection or radiofrequency ablation. Active investigation of SBRT has recently started, yielding promising local control rates. However, information on optimal treatment indications, doses, and methods remains limited. In HCC, significant differences in patient characteristics and treatment availability exist by country. Further studies are required to validate and maximize the efficacy of SBRT.