Radiotherapy for liver malignancies

Liver malignancies include primary liver cancer (hepato-cellular carcinoma [HCC], cholangiocarcinoma) and liver metastases. The incidence of primary liver cancer is increasing in the UK and in the last decade the incidence rates of HCC have increased by 60% with mortality increasing at a similar pace. Surgical resection and transplantation (for HCC) are traditionally regarded as the most effective forms of therapy. Unfortunately, a large number of patients are not eligible for surgical treatments due to extensive disease or medical comorbidities. The non-operative treatment approaches include novel systemic therapies, ablative therapies (radiofrequency ablation or microwave ablation), transarterial chemoembolisation (for HCC) and external beam radiotherapy. As modern technology and current practice have evolved we are able now to safely deliver radiation to limited volumes of liver in many patients, but challenges remain in terms of technical and clinical aspects.

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