Role of SBRT in HCC Management

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

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

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

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

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

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

[object Object],[object Object],HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25% Survival 50 - 80% Ablation Survival 10 - 50% TACE Survival 30 - 60%

[object Object],[object Object],HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25% Survival 50 - 80% Ablation Survival 10 - 50% TACE Survival 30 - 60% ,[object Object],[object Object],[object Object]

Radiation Therapy: Important therapeutic modality ,[object Object],[object Object],[object Object]

Radiation Therapy: Important therapeutic modality ,[object Object],DNA repair Cell cycle regulation Apoptosis

Radiation Therapy: Important therapeutic modality ,[object Object],[object Object]

Radiation Therapy: Important therapeutic modality ,[object Object],[object Object],[object Object],Repair Normal Tissue > tumor Repopulation Normal Tissue, Some tumors Redistribution Not significant Reoxygenation Tumors

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Radiation Therapy: Important therapeutic modality

Radiation Therapy: Important therapeutic modality ,[object Object],[object Object],[object Object],[object Object],[object Object],TV IV Less conformal More conformal TV

Emerging Role for Radiation Therapy in HCC: Why not in intra-hepatic malignancies? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Emerging Role for Radiation Therapy in HCC ,[object Object]

Emerging Role for Radiation Therapy in HCC: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Emerging Role for Radiation Therapy in HCC: Dependent on Advances in imaging ,[object Object],[object Object],[object Object],[object Object]

Emerging Role for Radiation Therapy in HCC: Stereotactic Body Radiotherapy (SBRT) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Experimental Questions

[object Object],[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Experimental Questions

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Experimental Questions

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Experimental Questions

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Montefiore-Einstein Liver SBRT Pilot Project

[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Montefiore-Einstein Liver SBRT Pilot Project

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Potential Future Directions

Multidisciplinary Team ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Hepatology Paul Gaglio John Reinus Pathology Quiang Lu Kathryn Tanaka Surgery Milan Kinkhabwala Funding: Paul Calabresi Award in Clinical Oncology (K12) Prinicipal Investigator: Roman Perez-Soler

Role of SBRT in HCC Management

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Role of SBRT in HCC Management

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