Yeungnam Univ J Med.  2019 Sep;36(3):192-200. 10.12701/yujm.2019.00269.

Current status of stereotactic body radiotherapy for the treatment of hepatocellular carcinoma

• Park J
• Park JW
• Kang MK

• KMID: 2460187
• DOI: http://doi.org/10.12701/yujm.2019.00269

Abstract

Stereotactic body radiotherapy (SBRT) is an advanced form of radiotherapy (RT) with a growing interest on its application in the treatment of hepatocellular carcinoma (HCC). It can deliver ablative radiation doses to tumors in a few fractions without excessive doses to normal tissues, with the help of advanced modern RT and imaging technologies. Currently, SBRT is recommended as an alternative to curative treatments, such as surgery and radiofrequency ablation. This review discusses the current status of SBRT to aid in the decision making on how it is incorporated into the HCC management.

Keyword

Hepatocellular carcinoma; Image-guided radiotherapy; Radiotherapy; Stereotactic body radiotherapy

MeSH Terms

Carcinoma, Hepatocellular*
Catheter Ablation
Decision Making
Radiosurgery*
Radiotherapy
Radiotherapy, Image-Guided

Figure

• 

  Fig. 1. An example of stereotactic body radiotherapy using tracking intensity-modulated beams for a 20-mm-sized lesion in segment 1 that occurred after right hepatectomy and 5 times of radiofrequency ablation. (A) Gold fiducial markers are inserted before the simulation for patient/tumor position verification and real-time tumor tracking. (B, C) Target volumes and normal tissues are delineated in breath-hold images, and then treatment plan using 9 intensity-modulated beams is generated (gross tumor volume in red, planning target volume in cyan, and the intestine in green). (D) In the treatment room, locations of fiducial markers are verified using cone-beam computed tomography. (E) The treatment beams are delivered while monitoring the movement of the fiducial markers in real time. Electronic portal imaging device shows the movement of each beamlet during tracking treatment. Images in B, C, and E are from this patient, and images in A and D are from other patients for demonstration.

Reference

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