Radiotherapy for HCC: Ready for prime time?

Bang, Andrew; Dawson, Laura A.

doi:10.1016/j.jhepr.2019.05.004

Cited by 53 publications

(45 citation statements)

References 39 publications

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“…Nonetheless, new evidence is emerging on the efficacy of stereotactic beam radiotherapy (SBRT) and proton beam therapy (PBT) for the treatment of localized HCC. 92,93 With the help of protons, tumors can be targeted more precisely, reaching a higher radiation dose within the tumor and further sparing functional liver tissue and therefore decreasing the risk of long-term adverse effects. 94 However, evidence for the application of PBT remains limited, as long-term outcomes are still to be evaluated.…”

Section: Intra-arterial Interventionsmentioning

confidence: 99%

The therapeutic landscape of hepatocellular carcinoma

Gallage

García‐Beccaria

Szydlowska

et al. 2021

Med

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The liver is endowed with an amazing regenerative capacity that allows it to withstand an enormous amount of damage. Nevertheless, it is precisely this highly regenerative capacity that renders it susceptible to dysplasia and liver cancer. Liver cancer is not only one of the most common cancers but also one of the deadliest. Hepatocellular carcinoma (HCC) is the most common form of liver cancer, accounting for up to 70%-90% of all cases, but treatment options for advanced stages remain scarce. Therefore, a great deal of effort has gone into identifying early diagnostic markers as well as novel therapies, both local and systemic, for the treatment of this deadly disease. In this review, we aim to shed light into the current therapeutic landscape of HCC with an emphasis on the available treatments, ranging from surgical and local-ablative therapy for early and intermediate stages of the disease to systemic therapies for advanced cancer treatments. We will also address the molecular mechanisms and limitations of currently available systemic therapies and the causes of treatment resistance and finally summarize the emerging future avenues and novel concepts that are promising.

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Section: Intra-arterial Interventionsmentioning

confidence: 99%

The therapeutic landscape of hepatocellular carcinoma

Gallage

García‐Beccaria

Szydlowska

et al. 2021

Med

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“…During the last decade, HCC is generally considered to be a radiosensitive tumor ( 49 ). However, most international guidelines still do not recommend ERT to treat HCC with few exceptions due to the severe hepatotoxicity of the normal tissues after absorbing radiation more than 35 Gy.…”

Section: Discussionmentioning

confidence: 99%

Comparative Effectiveness of Adjuvant Treatment for Resected Hepatocellular Carcinoma: A Systematic Review and Network Meta-Analysis

Liu¹,

Wang²,

Guo³

et al. 2021

Front. Oncol.

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BackgroundIt is controversial whether adjuvant treatment could be recommended for hepatocellular carcinoma (HCC) after curative hepatectomy. Thus, we performed a network meta-analysis (NMA) to assess adjuvant treatment’s benefit and determine the optimal adjuvant regimen.MethodsWe systematically searched PubMed, Embase, and Cochrane Library for randomized controlled trials comparing adjuvant therapy versus no active treatment after curative hepatectomy among patients with HCC. Pooled data on recurrence and overall survival (OS) were analyzed within pairwise meta-analysis and NMA.ResultsTwenty-three eligible trials (3,940 patients) reporting eight treatments were included. The direct meta-analysis showed that adjuvant therapy prevented the recurrence (OR = 0.65; 95% CI: 0.55, 0.77; P = 0.177; I2 = 21.7%) and contributed to OS (HR = 0.63; 95% CI: 0.54, 0.73; P = 0.087; I2 = 31.1%) in comparison to the observation. In the NMA, internal radiotherapy (IRT; OR = 0.55; 95% CI: 0.39, 0.77; SUCRA = 87.7%) followed by hepatic artery infusion chemotherapy (HAIC; OR = 0.6; 95% CI: 0.36, 0.97; SUCRA = 77.8%), and HAIC (HR = 0.44; 95% CI: 0.21, 0.87; SUCRA = 82.6%) followed by IRT (HR 0.54; 95% CI:0.36, 0.81; SUCRA = 69.7%) were ranked superior to other treatments in terms of preventing recurrence and providing survival benefit, respectively.ConclusionsThe addition of adjuvant therapy lowers the risk of recurrence and provide survival benefit after surgical resection for HCC. HAIC and IRT are likely to be the two most effective adjuvant regimens.Systematic Review Registrationhttps://inplasy.com/inplasy-2020-11-0039/.

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“…Image-guided radiation therapy has made tremendous progress. 61 The mainstay for downstaging and bridging therapies still are ablation and TACE. However, they are contraindicated in patients with decompensated cirrhosis and often restricted by size or location of the tumours.…”

Section: Macrovascular Invasion Of Hepatic or Portal Veins Is Presentmentioning

confidence: 99%

“…Image‐guided radiation therapy has made tremendous progress 61 . The mainstay for downstaging and bridging therapies still are ablation and TACE.…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

Recent developments and ongoing trials in transplant oncology

Moeckli

Ivanics

Claasen

et al. 2020

Liver International

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More than half a century has passed since the first successful liver transplantation (LT) by Thomas Starzl and this groundbreaking therapy has now become an established treatment for various indications. 1 This is reflected by more than 8000 LT performed in 2018 in the US alone and a 5-year post-transplant survival exceeding 75%. 2 Most transplants are still performed for end-stage liver failure. However, the proportion of LT performed for oncological indications is constantly rising and cancer now represents the main indication for >20% of all transplants worldwide, giving rise to a new field coined "transplant oncology". 2,3 This trend is attributable to great improvements in the perioperative care, the ability to decrease immunosuppression without an increase in rejection and several surgical innovations that helped to increase the donor pool. 4 It will likely continue with less patients requiring LT for viral

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Radiotherapy for HCC: Ready for prime time?

Cited by 53 publications

References 39 publications

The therapeutic landscape of hepatocellular carcinoma

The therapeutic landscape of hepatocellular carcinoma

Comparative Effectiveness of Adjuvant Treatment for Resected Hepatocellular Carcinoma: A Systematic Review and Network Meta-Analysis

Recent developments and ongoing trials in transplant oncology

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