Consensus for Radiotherapy in Hepatocellular Carcinoma from the 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014): Current Practice and Future Clinical Trials

Hee Chul Park, Jeong Il Yu, Jason Chia Hsien Cheng, Zhao Chong Zeng, Ji Hong Hong, Michael Lian Chek Wang, Mi Sook Kim, Kwan Hwa Chi, Po Ching Liang, Rheun Chuan Lee, Wan Yee Lau, Kwang Hyub Han, Pierce Kah Hoe Chow, Jinsil Seong

Research output: Contribution to journalReview article

28 Citations (Scopus)

Abstract

A consensus meeting to develop practice guidelines and to recommend future clinical trials for radiation therapy (RT), including external beam RT (EBRT), and selective internal RT (SIRT) in hepatocellular carcinoma (HCC) was held at the 5th annual meeting of the Asia-Pacific Primary Liver Cancer Expert consortium. Although there is no randomized phase III trial evidence, the efficacy and safety of RT in HCC has been shown by prospective and retrospective studies using modern RT techniques. Based on these results, the committee came to a consensus on the utility and efficacy of RT in the management of HCC according to each disease stage as follows: in early and intermediate stage HCC, if standard treatment is not compatible, RT, including EBRT and SIRT can be considered. In locally advanced stage HCC, combined EBRT with transarterial chemoembolization or hepatic arterial infusion chemotherapy, and SIRT can be considered. In terminal stage HCC, EBRT can be considered for palliation of symptoms and reduction of morbidity caused by the primary tumor or its metastases. Despite the currently reported benefits of RT in HCC, the committee agreed that there is a compelling need for large prospective studies, including randomized phase III trial evidence evaluating the role of RT. Specifically studies evaluating the efficacy and safety of sequential combination of EBRT and SIRT are strongly recommended.

Original languageEnglish
Pages (from-to)162-174
Number of pages13
JournalLiver Cancer
Volume5
Issue number3
DOIs
Publication statusPublished - 2016 Jul 1

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Oncology

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    Park, H. C., Yu, J. I., Cheng, J. C. H., Zeng, Z. C., Hong, J. H., Wang, M. L. C., Kim, M. S., Chi, K. H., Liang, P. C., Lee, R. C., Lau, W. Y., Han, K. H., Chow, P. K. H., & Seong, J. (2016). Consensus for Radiotherapy in Hepatocellular Carcinoma from the 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014): Current Practice and Future Clinical Trials. Liver Cancer, 5(3), 162-174. https://doi.org/10.1159/000367766