| Zhao Qianqian,Zeng Zhaochong.Advances in radiotherapy for unresectable early-stage hepatocellular carcinoma: A 2024 evidence-based update[J].Chinese Journal of Radiological Medicine and Protection,2026,46(1):90-92 |
| Advances in radiotherapy for unresectable early-stage hepatocellular carcinoma: A 2024 evidence-based update |
| Received:July 12, 2025 |
| DOI：10.3760/cma.j.cn112271-20250712-00247 |
| KeyWords:Early-stage hepatocellular carcinoma Unresectable Radiotherapy |
| FundProject:国家自然科学基金(82373519);国家重点研发计划项目(2022YFC2503704) |
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| Abstract:: |
| Amid the rapidly evolving landscape of systemic therapy for advanced hepatocellular carcinoma (HCC), radiotherapy for unresectable early-stage HCC (NCLC stage 1A-2A) has gained prominence owing to its favorable cost-effectiveness profile. This review, grounded in China's National Health Commission Guidelines for the Diagnosis and Treatment of Primary Liver Cancer and the Consensus Statements on Radiotherapy for HCC, systematically synthesizes the latest evidence on radiotherapy for this subpopulation. Through integrated analysis of prospective randomized controlled trials and multicenter retrospective cohorts, we conducted a comprehensive evaluation of the efficacy for stereotactic body radiotherapy (SBRT), radiofrequency ablation (RFA), and transarterial chemoembolization combined with radiotherapy (TACE+RT). Our analysis reveals that for unresectable lesions ≤5 cm, particularly those in high-risk anatomical locations (e.g., adjacent to major vessels or the diaphragm), SBRT represents the preferred therapeutic strategy. For lesions >5 cm, TACE+RT significantly improves 3-year local control rates compared to TACE alone (56.6% vs. 17.8%, P = 0.0015), while reducing the mean number of TACE sessions by 2.1. Thus, in the era of rapidly expanding advanced therapeutics, personalized selection of SBRT or TACE+RT achieves oncological outcomes comparable to surgical resection. These findings establish an evidence-based framework for precision radiotherapy in unresectable early-stage HCC. |
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