Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Copyright © 2021 by The Korean Liver Cancer Association
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AUTHOR CONTRIBUTIONS
The author contributed solely to this article.
Conflicts of Interest
The authors declare no conflicts of interest relevant to this article.
RT, radiotherapy; APASL, Asia-Pacific Association for the Study of the Liver; SBRT, stereotactic body radiotherapy; HCC, hepatocellular carcinoma; PVTT, portal vein tumor thrombus; KLCA-NCC, Korean Liver Cancer Association-National Cancer Center; LT, liver transplantation; LRT, locoregional therapy; TACE, transarterial chemoembolization; JSH, Japan Society of Hepatology; 3D-CRT, 3-dimensional conformal radiotherapy; TLCA, Taiwan Liver Cancer Association; BCLC, Barcelona Clinic Liver Cancer; NHFPC, National Health and Family Planning Commission; IVCTT, inferior vena cava tumor thrombus; AASLD, American Association for the Study of Liver Diseases; EASL, European Association for the Study of the Liver; ESMO, European Society for Medical Oncology.
Affiliation | Country | Year | Evidence of RT | Recommendation of RT | Potential role of RT in clinical situations |
---|---|---|---|---|---|
APASL | Multinational (Asia) | 2017 | Low/very low | Weak |
SBRT for small HCC Particle therapy for large HCC or PVTT |
KLCA-NCC | Korea | 2018 | Low/moderate | Weak/strong |
RT for HCC ineligible for surgery, LT, other LRTs RT for incomplete response to TACE RT for HCC with PVTT (combined with TACE) Palliative RT for metastases |
JSH | Japan | 2017 | - | Weak |
SBRT for HCCs not indications for other LRTs Particle therapy for HCCs not eligible for other LRTs 3D-CRT when SBRT and particle therapy are not eligible (PVTT, unresectable HCC) |
TLCA | Taiwan | 2015 | Level 2 | Recommended |
Medically inoperable, refusal of standard treatment, bridge to transplant, unsuitable/refractory to TACE, localized HCC with symptoms, PVTT, symptomatic metastasis or oligo-metastasis in all BCLC stages |
NHFPC | China | 2017 | Level 3 | - |
RT for PVTT, IVCTT or extrahepatic metastases, bridge to LT, relieving symptoms Adjuvant RT for centrally located tumors with narrow surgical margins |
Hong Kong | 2015 | Level 4/5 | - |
RT for effective local control, a viable portion for unresectable HCC, combined with TACE for unresectable HCC SBRT as an alternative to ablation and a bridging therapy before LT | |
AASLD | United States | 2018 | Level 2 | - |
SBRT as an alternative to thermal ablation |
EASL | Multinational (Europe) | 2018 | Low | Weak |
RT in combination with TACE SBRT as a bridge to LT RT for PVTT Palliative RT for pain, impending fracture |
ESMO | Multinational (Europe) | 2018 | Level 3 | B/C |
SBRT as alternatives for the ablation Palliative RT for bone metastases |
RT, radiotherapy; APASL, Asia-Pacific Association for the Study of the Liver; SBRT, stereotactic body radiotherapy; HCC, hepatocellular carcinoma; PVTT, portal vein tumor thrombus; KLCA-NCC, Korean Liver Cancer Association-National Cancer Center; LT, liver transplantation; LRT, locoregional therapy; TACE, transarterial chemoembolization; JSH, Japan Society of Hepatology; 3D-CRT, 3-dimensional conformal radiotherapy; TLCA, Taiwan Liver Cancer Association; BCLC, Barcelona Clinic Liver Cancer; NHFPC, National Health and Family Planning Commission; IVCTT, inferior vena cava tumor thrombus; AASLD, American Association for the Study of Liver Diseases; EASL, European Association for the Study of the Liver; ESMO, European Society for Medical Oncology.