Abstract
With technical improvements, radiotherapy (RT) has been adopted as an initial treatment modality for locally advanced hepatocellular carcinoma (HCC). Even though assessment of the resectability of HCC is still a controversial issue, neoadjuvant RT should be differentiated from downstaging treatment with RT because the aim of RT and timing of liver resection differ between the two approaches. In this chapter, the roles of neoadjuvant and downstaging RT in treating locally advanced HCC are investigated through a review of the literature.
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References
Lim KC, Chow PK, Allen JC, Siddiqui FJ, Chan ES, Tan SB. Systematic review of outcomes of liver resection for early hepatocellular carcinoma within the Milan criteria. Br J Surg. 2012;99(12):1622–9.
European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182–236.
Korean Liver Cancer Association, National Cancer Center. 2018 Korean Liver Cancer Association-National Cancer Center. Korea practice guidelines for the management of hepatocellular carcinoma. Gut Liver. 2019;13(3):227–99.
Guglielmi A, Ruzzenente A, Conci S, Valdegamberi A, Iacono C. How much remnant is enough in liver resection? Dig Surg. 2012;29(1):6–17.
Poon RT, Cheung TT, Kwok PC, Lee AS, Li TW, Loke KL, et al. Hong Kong consensus recommendations on the management of hepatocellular carcinoma. Liver Cancer. 2015;4(1):51–69.
Nakayama H, Takayama T. Role of surgical resection for hepatocellular carcinoma based on Japanese clinical guidelines for hepatocellular carcinoma. World J Hepatol. 2015;7(2):261–9.
Kokudo T, Hasegawa K, Matsuyama Y, Takayama T, Izumi N, Kadoya M, et al. Survival benefit of liver resection for hepatocellular carcinoma associated with portal vein invasion. J Hepatol. 2016;65(5):938–43.
Wei X, Jiang Y, Zhang X, Feng S, Zhou B, Ye X, et al. Neoadjuvant three-dimensional conformal radiotherapy for resectable hepatocellular carcinoma with portal vein tumor thrombus: a randomized, open-label, multicenter controlled study. J Clin Oncol. 2019;37(24):2141–51.
Yu JI, Park HC, Lim DH, Kim CJ, Oh D, Yoo BC, et al. Scheduled interval trans-catheter arterial chemoembolization followed by radiation therapy in patients with unresectable hepatocellular carcinoma. J Korean Med Sci. 2012;27(7):736–43.
Kang JK, Kim MS, Cho CK, Yang KM, Yoo HJ, Kim JH, et al. Stereotactic body radiation therapy for inoperable hepatocellular carcinoma as a local salvage treatment after incomplete transarterial chemoembolization. Cancer. 2012;118(21):5424–31.
Lee HS, Choi GH, Choi JS, Kim KS, Han KH, Seong J, et al. Surgical resection after down-staging of locally advanced hepatocellular carcinoma by localized concurrent chemoradiotherapy. Ann Surg Oncol. 2014;21(11):3646–53.
Rim CH, Park S, Woo JY, Seong J. Compensatory hypertrophy of the liver after external beam radiotherapy for primary liver cancer. Strahlenther Onkol. 2018;194(11):1017–29.
Lau WY, Lai EC. Salvage surgery following downstaging of unresectable hepatocellular carcinoma--a strategy to increase resectability. Ann Surg Oncol. 2007;14(12):3301–9.
Sitzmann JV, Abrams R. Improved survival for hepatocellular cancer with combination surgery and multimodality treatment. Ann Surg. 1993;217(2):149–54.
Lau WY, Ho SK, Yu SC, Lai EC, Liew CT, Leung TW. Salvage surgery following downstaging of unresectable hepatocellular carcinoma. Ann Surg. 2004;240(2):299–305.
Akateh C, Black SM, Conteh L, Miller ED, Noonan A, Elliott E, et al. Neoadjuvant and adjuvant treatment strategies for hepatocellular carcinoma. World J Gastroenterol. 2019;25(28):3704–21.
Han KH, Seong J, Kim JK, Ahn SH, Lee DY, Chon CY. Pilot clinical trial of localized concurrent chemoradiation therapy for locally advanced hepatocellular carcinoma with portal vein thrombosis. Cancer. 2008;113(5):995–1003.
Chong JU, Choi GH, Han DH, Kim KS, Seong J, Han KH, et al. Downstaging with localized concurrent chemoradiotherapy can identify optimal surgical candidates in hepatocellular carcinoma with portal vein tumor thrombus. Ann Surg Oncol. 2018;25(11):3308–15.
Lee WH, Byun HK, Choi JS, Choi GH, Han DH, Joo DJ, et al. Liver-directed combined radiotherapy as a bridge to curative surgery in locally advanced hepatocellular carcinoma beyond the milan criteria. Radiother Oncol. 2020;152:1–7.
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Choi, G.H. (2021). Neoadjuvant Radiotherapy Converting to Curative Resection. In: Seong, J. (eds) Radiotherapy of Liver Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-16-1815-4_15
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DOI: https://doi.org/10.1007/978-981-16-1815-4_15
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