title: Therapeutic Strategies in HCC: Radiation Modalities.
abstract: Patients with hepatocellular carcinoma (HCC) comply with an advanced disease and are not eligible for radical therapy. In this distressed scenario new treatment options hold great promise; among them transarterial chemoembolization (TACE) and transarterial metabolic radiotherapy (TAMR) have shown efficacy in terms of both tumor shrinking and survival. External radiation therapy (RTx) by using novel three-dimensional conformal radiotherapy has also been used for HCC patients with encouraging results while its role had been limited in the past for the low tolerance of surrounding healthy liver. The rationale of TAMR derives from the idea of delivering exceptional radiation dose locally to the tumor, with cell killing intent, while preserving normal liver from undue exposition and minimizing systemic irradiation. Since the therapeutic efficacy of TACE is being continuously disputed, the TAMR with (131)I Lipiodol or (90)Y microspheres has gained consideration providing adequate therapeutic responses regardless of few toxicities. The implementation of novel radioisotopes and technological innovations in the field of RTx constitutes an intriguing field of research with important translational aspects. Moreover, the combination of different therapeutic approaches including chemotherapy offers captivating perspectives. We present the role of the radiation-based therapies in hepatocellular carcinoma patients who are not entitled for radical treatment.
authors: Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Via P. Pio 1, 85028 Rionero in Vulture, Italy.
authors: R
authors: R
authors: Gallicchio
authors: Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, 80145 Napoli, Italy.
authors: A
authors: A
authors: Nardelli
authors: Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, 80145 Napoli, Italy.
authors: P
authors: P
authors: Mainenti
authors: Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Via P. Pio 1, 85028 Rionero in Vulture, Italy.
authors: A
authors: A
authors: Nappi
authors: Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Via P. Pio 1, 85028 Rionero in Vulture, Italy.
authors: D
authors: D
authors: Capacchione
authors: Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Via P. Pio 1, 85028 Rionero in Vulture, Italy.
authors: V
authors: V
authors: Simeon
authors: Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, 80145 Napoli, Italy.
authors: C
authors: C
authors: Sirignano
authors: Oncology Unit, IRCCS Giovanni Paolo II, 70124 Bari, Italy.
authors: F
authors: F
authors: Abbruzzi
authors: CMO Oplonti Medical Centre, 80058 Torre Annunziata, Italy.
authors: F
authors: F
authors: Barbato
authors: Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Via P. Pio 1, 85028 Rionero in Vulture, Italy; Oncology Unit, Università degli Studi di Foggia, 71122 Foggia, Italy.
authors: M
authors: M
authors: Landriscina
authors: Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Via P. Pio 1, 85028 Rionero in Vulture, Italy.
authors: G
authors: 0000-0002-6168-5598
authors: G
authors: Storto
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D059248:Chemoradiotherapy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*