1. Role of modern radiotherapy in managing patients with hepatocellular carcinoma
- Author
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Hon-Yi Lin, Moon-Sing Lee, Shih-Kai Hung, Wen-Yen Chiou, and Liang-Cheng Chen
- Subjects
Oncology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Hepatocellular carcinoma ,Combined treatment ,medicine.medical_treatment ,Review ,Guideline ,Radiosurgery ,Systemic therapy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Modalities ,Radiotherapy ,business.industry ,Liver Neoplasms ,Gastroenterology ,General Medicine ,Immunotherapy ,Stereotactic body radiotherapies ,medicine.disease ,Radiation therapy ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Neoplasm Recurrence, Local ,Primary liver cancer ,business ,Stereotactic body radiotherapy - Abstract
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Several treatment options are available for managing HCC patients, classified roughly as local, local-regional, and systemic therapies. The high post-monotherapy recurrence rate of HCC urges the need for the use of combined modalities to increase tumor control and patient survival. Different international guidelines offer treatment recommendations based on different points of view and classification systems. Radiotherapy (RT) is a well-known local-regional treatment modality for managing many types of cancers, including HCC. However, only some of these treatment guidelines include RT, and the role of combined modalities is rarely mentioned. Hence, the present study reviewed clinical evidence for the use of different combined modalities in managing HCC, focusing on modern RT's role. Modern RT has an increased utility in managing HCC patients, mainly due to two driving forces. First, technological advancement (e.g., stereotactic body radiotherapy and advanced proton-beam therapy) enables precise delivery of radiation to increase tumor control and reduce side effects in the surrounding normal tissue. Second, the boom in developing target therapies and checkpoint-blockade immunotherapy prolongs overall survival in HCC patients, re-emphasizing the importance of local tumor control. Remarkably, RT combines with systemic therapies to generate the systemic therapy augmented by radiotherapy effect, a benefit now being actively investigated.
- Published
- 2021
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