John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Radiotherapy in the management of hepatocellular carcinoma Volume 23, issue 4, Avril 2016

Authors
1 Hôpital de la Pitié-Salpêtrière,
Service d’Oncologie-Radiothérapie,
47-83, boulevard de l’Hôpital,
75651 Paris Cedex 13, France
2 Hôpital de la Croix-Rousse,
service d’hépato-gastro-entérologie,
103 Grande Rue de la Croix-Rousse,
69317 Lyon Cedex 04, France ;
UMR INSERM U1052, CNRS 5286,
Université Claude Bernard, Lyon 1, France
3 Centre Hospitalier Lyon-Sud,
service de radiothérapie-oncologie,
165, Chemin du Grand Revoyet,
69310 Pierre-Bénite, France ;
EMR 3738, Université Claude Bernard, Lyon 1,
France
* Tirés à part

Radiotherapy constitutes an efficient local treatment of various cancers. Hepatocellular carcinoma (HCC) is a radiosensitive malignant tumour. Despite this rationale, radiotherapy was rarely implemented in patients with HCC. The high prevalence of liver cirrhosis among patients and the potentially severe radiation-induced toxicities, especially hepatitis, have represented a critical issue for a long time. As other antineoplastic treatments, radiotherapy achieved significant technical progresses. These improvements, like intensity-modulated radiation therapy or stereotactic body radiotherapy, share as main principle the administration of higher doses to the target volume while sparing more safely the neighboring organs, especially the non-tumoural liver. The irradiation has become sharper due to an improved reproducibility. Respiratory-gated or image-guided radiotherapy developed and reduce the healthy tissues exposure to ionizing radiation. Many studies, retrospective and prospective, have highlighted the efficacy of radiotherapy as a treatment of HCC, as well as a low incidence of adverse effects.