title: Role of radiotherapy in the management of hepatocellular carcinoma: A systematic review.
abstract: Many patients with hepatocellular carcinoma (HCC) present with advanced disease, not amenable to curative therapies such as surgery, transplantation or radiofrequency ablation. Treatment options for this group of patients include transarterial chemoembolization (TACE) and radiation therapy. Especially TACE, delivering a highly concentrated dose of chemotherapy to tumor cells while minimizing systemic toxicity of chemotherapy, has given favorable results on local control and survival. Radiotherapy, as a therapeutic modality of internal radiation therapy with radioisotopes, has also achieved efficacious tumor control in advanced disease. On the contrary, the role of external beam radiotherapy for HCC has been limited in the past, due to the low tolerance of surrounding normal liver parenchyma. However, technological innovations in the field of radiotherapy treatment planning and delivery, have provided the means of delivering radical doses to the tumor, while sparing normal tissues. Advanced and highly conformal radiotherapy approaches such as stereotactic body radiotherapy and proton therapy, evaluated for efficacy and safety for HCC, report encouraging results. In this review, we present the role of radiotherapy in hepatocellular carcinoma patients not suitable for radical treatment.
authors.affiliation: Maria-Aggeliki Kalogeridi, Anna Zygogianni, George Kyrgias, Radiotherapy Department, Larissa University Hospital, 41110 Larisa, Greece.
authors.forename: Maria-Aggeliki
authors.initials: MA
authors.lastname: Kalogeridi
authors.affiliation: Maria-Aggeliki Kalogeridi, Anna Zygogianni, George Kyrgias, Radiotherapy Department, Larissa University Hospital, 41110 Larisa, Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Zygogianni
authors.affiliation: Maria-Aggeliki Kalogeridi, Anna Zygogianni, George Kyrgias, Radiotherapy Department, Larissa University Hospital, 41110 Larisa, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Kyrgias
authors.affiliation: Maria-Aggeliki Kalogeridi, Anna Zygogianni, George Kyrgias, Radiotherapy Department, Larissa University Hospital, 41110 Larisa, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kouvaris
authors.affiliation: Maria-Aggeliki Kalogeridi, Anna Zygogianni, George Kyrgias, Radiotherapy Department, Larissa University Hospital, 41110 Larisa, Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Chatziioannou
authors.affiliation: Maria-Aggeliki Kalogeridi, Anna Zygogianni, George Kyrgias, Radiotherapy Department, Larissa University Hospital, 41110 Larisa, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kelekis
authors.affiliation: Maria-Aggeliki Kalogeridi, Anna Zygogianni, George Kyrgias, Radiotherapy Department, Larissa University Hospital, 41110 Larisa, Greece.
authors.forename: Vassilis
authors.initials: V
authors.lastname: Kouloulias
keywords: Hepatocellular carcinoma; Hyperthermia; Radio-embolization; Radiotherapy; Review