1. Radiation therapy has an emerging role in the multidisciplinary management of hepatocellular carcinoma (HCC) due to advances that allow higher radiation doses to be safely delivered to small liver volumes. 2. Stereotactic body radiation therapy (SBRT) shows promise for HCC but questions remain about safety, effectiveness for bridging to transplant, and downsizing lesions. 3. A pilot study is investigating the safety and feasibility of liver SBRT for HCC.

1. Role of Radiation Therapy in Multidisciplinary Management of Hepatocellullar Carcinoma Darlene Gabeau, M.D., Ph.D. Assistant Professor Department of Radiation Oncology Department of Radiation Oncology

2. HCC : Standard Treatment Algorithm Barcelona Clinic Liver Cancer System Llovet, J. M. et al. J. Natl. Cancer Inst. 2008 100:698-711

3. HCC : Standard Treatment Algorithm Barcelona Clinic Liver Cancer System Llovet, J. M. et al. J. Natl. Cancer Inst. 2008 100:698-711

4. HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25%

5. HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25% Survival 50 - 80%

6. HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25% Survival 50 - 80% Ablation Survival 10 - 50%

7. HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25% Survival 50 - 80% Ablation Survival 10 - 50% TACE Survival 30 - 60%