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KMID : 0964020130130020114
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Journal of the Korean Liver Cancer Study Group
2013 Volume.13 No. 2 p.114 ~ p.122
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Role of Radiation Therapy as an Ablative Modality for Hepatocellular Carcinoma
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Park Hee-Chul
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Abstract
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Before the introduction of radiation therapy (RT) in the clinical management guidelines for hepatocellular carcinoma (HCC), radiation was used not very frequently in the course of HCC management. According to the “Practice guidelines for management of HCC 2009” published by the Korean Liver Cancer Study Group and the National Cancer Center, Korea, RT can be used for HCC with portal vein tumor thrombosis and can be effective to relieve the symptoms caused by HCC and its metastases once the RT is believed safe in terms of radiobiological considerations. The introduction of RT in the Korean HCC management guideline did the pivotal role in accentuating research efforts to enlighten the role of RT in HCC management. Recently, the application of stereotactic ablative body radiotherapy (SABR), an extra-cranial version of radiosurgery such as Gamma-knife, is tested as an ablative modality for HCC. There are already some published prospective series to test SABR for HCC. In Korea, there is a prospective trial published by Korea Cancer Center Hospital. A multicenter prospective trial (KROG 12-02) is on-going as a Korean Radiation Oncology Group (KROG) study and already 26 patients were accrued to the target number of 54 patients. In this review, the background, rationale and the discussion points in the application of SABR as an ablative modality for HCC will be covered. And the experience of hypofractionated ablative RT for small size HCC less than 3 cm by the author will be introduced.
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KEYWORD
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Hepatocellular carcinoma, Radiation therapy, Stereotactic ablative body radiotherapy
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