Technical advances in external radiotherapy for hepatocellular carcinoma |
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Authors: | Shin-Hyung Park Jae-Chul Kim Min Kyu Kang |
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Institution: | Shin-Hyung Park, Department of Radiation Oncology, Kyungpook National University Hospital, Daegu 41944, South KoreaJae-Chul Kim, Min Kyu Kang, Department of Radiation Oncology, Kyungpook National University School of Medicine, Daegu 41944, South Korea |
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Abstract: | Radiotherapy techniques have substantially improved in the last two decades. After the introduction of 3-dimensional conformal radiotherapy, radiotherapy has been increasingly used for the treatment of hepatocellular carcinoma(HCC). Currently, more advanced techniques, including intensity-modulated radiotherapy(IMRT), stereotactic ablative body radiotherapy(SABR), and charged particle therapy, are used for the treatment of HCC. IMRT can escalate the tumor dose while sparing the normal tissue even though the tumor is large or located near critical organs. SABR can deliver a very high radiation dose to small HCCs in a few fractions, leading to high local control rates of 84%-100%. Various advanced imaging modalities are used for radiotherapy planning and delivery to improve the precision of radiotherapy. These advanced techniques enable the delivery of high dose radiotherapy for early to advanced HCCs without increasing the radiation-induced toxicities. However, as there have been no effective tools for the prediction of the response to radiotherapy or recurrences within or outside the radiation field, future studies should focus on selecting the patients who will benefit from radiotherapy. |
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Keywords: | Hepatocellular carcinoma Radiotherapy 3D-conformal radiotherapy Intensity-modulated radiotherapy stereotactic ablative body radiotherapy Charged particle therapy Image-guided radiotherapy |
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