Controversies in Radiotherapy for Hepatocellular Carcinoma
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Radiation therapy for liver carcinomas has been used in some hospitals in North America and Europe, but widely in Asia. However, the role of radiation therapy in the management of liver carcinoma has not been recognized in liver cancer society, especially in North America and Europe. The modern radiation techniques, 3-dimensional radiation therapy, intensity-modulated radiation therapy, stereotactic body radiotherapy, and proton and carbon ion beam radiation therapy have yielded very encouraging outcome. Recently, the role of radiation therapy just started to be recognized by NCCN guideline.
In the radiation therapy society, there were controversies regarding the radiation techniques: (1) What was the optimal management to control target motion, especially for beam scanning delivery in proton and carbon ion therapy? (2) What were the optimal radiation fractionation and total dose for hypofractionated or stereotactic body radiation therapy? (3) What were the normal liver tolerances for the livers with different degrees of hepatic cirrhosis, when different irradiation fractionations and total doses were applied? (4) What were the appropriate indications for different radiation techniques?
KeywordsDose fractionation Moving target Normal liver irradiation tolerance Proton and carbon ion SBRT
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