Abstract: The role of ablative stereotactic body radiotherapy (SBRT) in hepatocellular carcinoma (HCC) has been evolving over the last few decades. SBRT has mostly been used in early stages of HCC, including few (≤ 3 in number) tumors, small tumours (< 3 cm in size), as well as larger tumours which are ineligible for other ablative modalities, mostly without vascular invasion. In early stage HCC, SBRT is used as a definitive treatment with curative intent or with intent to bridge to liver transplant. Retrospective and prospective institutional series document a high rate of local control (68– 95% at 3 years) following SBRT. This coupled with a low risk of toxicity makes this non-invasive ablative treatment an attractive option for patients who are ineligible for other ablative treatments. Small randomized studies of ablative radiation have also shown non-inferiority of radiation as compared to radiofrequency ablation (RFA). Currently, SBRT is widely available as a safe and effective liver directed therapy, although there is a need for more studies providing higher level evidence. This review gives a brief overview of SBRT and the evidence for its use in HCC patients with ablative intent.

Keywords: hepatocellular carcinoma, radiotherapy, stereotactic body radiotherapy, SBRT, stereotactic ablative radiotherapy, SABR

中文翻译：

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肝细胞癌消融放射治疗的现状

摘要：在过去的几十年中，消融立体定向放疗 (SBRT) 在肝细胞癌 (HCC) 中的作用不断发展。SBRT 主要用于 HCC 的早期阶段，包括少数（≤ 3 个）肿瘤、小肿瘤（< 3 cm 大小）以及不适合其他消融方式的较大肿瘤，大多数没有血管侵犯。在早期 HCC 中，SBRT 被用作具有治愈性目的或旨在过渡到肝移植的最终治疗方法。回顾性和前瞻性机构系列记录了 SBRT 后的高局部控制率（3 年时为 68-95%）。这与低毒性风险相结合，使这种非侵入性消融治疗成为不适合其他消融治疗的患者的有吸引力的选择。与射频消融 (RFA) 相比，消融辐射的小型随机研究也显示了辐射的非劣效性。目前，SBRT 作为一种安全有效的肝脏定向疗法被广泛使用，尽管需要更多研究提供更高水平的证据。本综述简要概述了 SBRT 及其在具有消融意图的 HCC 患者中使用的证据。

关键词：肝细胞癌，放疗，立体定向放疗，SBRT，立体定向消融放疗，SABR