Radiation Therapy for Primary Liver Cancer

Radiation therapy is a type of treatment using ionizing radiation to kill cancer cells and has many indications in primary liver cancer. This chapter will describe the indications for radiation in both hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), the two most common types of primary liver cancer. It will also review several studies regarding radiation therapy for HCC and ICC and discuss areas of further investigation. It will also describe the treatment planning process for two specialized types of radiation: stereotactic body radiation therapy (SBRT) and intensity-modulated radiation therapy (IMRT). To summarize the indications of radiation therapy in primary liver cancer: for unresectable HCC and ICC, radiation may be used as one of many local therapy options to provide local control. For resectable HCC and ICC, radiation may be offered as adjuvant therapy after surgical resection to reduce the risk of local recurrence. As always, a multidisciplinary approach to the treatment of liver cancers is important in guiding the use of radiation.