Therapeutic Guidelines for Patients with Liver Cancer from the Perspective of Radiation Oncologists

Liver cancer has significant heterogeneities regarding its incidence, as well as disease etiology and characteristics among regions. Various staging systems have been developed, and the types of treatment available or commonly used for liver cancer are also different by region. Currently, there are more than 30 clinical guidelines for liver cancer treatment. In the past, external beam radiotherapy (EBRT) was used only for the purpose of palliation. Currently, EBRT is used for a variety of indications that range from curative approaches for early cases using techniques such as stereotactic body radiotherapy to bridging therapies for liver transplantation. EBRT is useful in locally advanced tumors by converting to curative surgery in selected cases and has also long been used for palliation. Nevertheless, data from radiotherapy studies are not yet sufficient and are often criticized for their low grades of evidence. This chapter reviews the current guidelines for the treatment of liver cancer from the perspective of radiation oncology and discusses how to apply them in clinical practice.