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Hepatocellular carcinoma (HCC) is the third leading cause of cancer ‐ related deaths globally. Nearly 80% of the patients with HCC are in the Asia region. Although radiation therapy (RT) is a frequently used treatment option for HCC, the recognition of RT differs according to the guidelines.
Liver Cancer Roundtable Members in Action
The 7th APAC (Asia-Pacific region) liver roundtable was held in Hiroshima, Japan on May 25th, 2024. Accuray started the liver cancer roundtable collaboration back in 2016. Each year leading experts in the field of liver cancer in Asia have joined together and work together to better understand the role of RT in the treatment of liver cancer.
Historically, RT has been less commonly used in the treatment of HCC due to concerns about liver toxicity and the risk of radiation-induced liver disease. Even with the recent advances in radiation techniques and technologies the therapeutic high dose of radiation delivered via stereotactic body radiation therapy (SBRT) are not well recognized.
What Clinical Evidence Have the Members of Liver Roundtable Achieved?
The meetings have allowed the members of the roundtable to build up clinical evidence of radiotherapy, especially SBRT in the treatment of liver cancer. It has also helped to facilitate improved radiotherapy clinical practice by producing a set of consensuses, guidelines and clinical evidence generation.
• 2017 : Consensus on SBRT for small-sized HCC has been reached and published .
• 2020 : Members from the group evaluated the current HCC practice guidelines and published views from radiation oncologists’ perspective in the Green Journal .
• 2020: The multi-national multi-center study on SBRT versus radiofrequency ablation in Asian patients with HCC was published with large cohort data in the Journal of Hepatology .
• 2021 : Dose-response relationship in SBRT for HCC: a pooled-analysis of an Asian liver radiation therapy group study was published in the Red Journal . And another multi-center retrospective study on radiotherapy for HCC in the caudate lobe was published in Frontiers in Oncology.
The Therapeutic Landscape is Evolving in the Treatment of Liver Cancer
As RT has been integrated into multi-modality treatment for HCC, the therapeutic landscape of HCC has evolved. The role of locoregional treatment has been well defined and the use of combined immunotherapy has been the standard of care in advanced disease. During the 7 th APAC liver roundtable, immunotherapy combined radiotherapy for HCC were discussed in depth.