Radiation therapy for liver cancer

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Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is sometimes used to treat liver cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.

Radiation therapy is given for different reasons. You may have radiation therapy to:

  • destroy the cancer cells in the body
  • keep the tumour small enough to meet the transplant eligibility criteria if you are waiting for a liver transplant (called bridging therapy)
  • relieve pain or control the symptoms of advanced liver cancer (called palliative therapy)

The following types of radiation therapy are most commonly used to treat liver cancer.

External radiation therapy

During external radiation therapy (also called external beam radiation therapy), a machine directs radiation through the skin to the tumour and some of the tissue around it.

Stereotactic body radiation therapy (SBRT) is a type of external radiation therapy that delivers very focused beams of high-dose radiation to tumours in difficult or hard-to-reach areas (such as the liver) in fewer treatment sessions. It creates many beams of radiation from different angles that meet at the tumour. The liver tumour receives a high dose of radiation, while the individual beams that travel through the surrounding tissue are a low dose. This helps to limit damage to healthy tissue around the tumour.

Internal radiation therapy

Internal radiation therapy places radioactive materials in the body. Larger doses of radiation can be given with internal radiation therapy than with external radiation therapy.

Transarterial radioembolization (TARE) is a type of internal radiation therapy that blocks the blood supply to a liver tumour and delivers radiation directly to the tumour. It uses small particles (called microspheres) loaded with a radioactive material called a radioactive isotope. The radioactive particles are injected through the hepatic artery directly into the tumour.

Side effects

Side effects can happen with any type of treatment for liver cancer, but everyone's experience is different. Some people have many side effects. Other people have only a few side effects.

During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. But damage to healthy cells can happen and may cause side effects. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the type of radiation therapy and the treatment schedule. Some common side effects of radiation therapy used for liver cancer are:

Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Questions to ask about radiation therapy

Find out more about radiation therapy and side effects of radiation therapy. To make the decisions that are right for you, ask your healthcare team questions about radiation therapy.

Expert review and references

  • Kelly W Burak, MD, FRCPC, MSc(Epid)
  • Vincent Tam, BSc(Hon), MD, FRCPC
  • American Cancer Society . Radiation Therapy for Liver Cancer . 2019 : https://www.cancer.org/.
  • Burak KW, Sherman M. Hepatocellular carcinoma: consensus, controversies and future directions: a report from the Canadian Association for the Study of the Liver hepatocellular carcinoma meeting. Canadian Journal of Gastroenterology and Hepatology. 2015: 29(4):178–184. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444026/.
  • European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatocellular carcinoma. Journal of Hepatology. 2018: 69:182–236. https://www.journal-of-hepatology.eu/article/S0168-8278(18)30215-0/fulltext.
  • Fong Y, Dupuy DE, Feng M, Abou-Alfa G. Cancer of the liver. DeVita VT Jr., Lawrence TS, Rosenberg SA, eds.. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, PA: Wolters Kluwer; 2019: 57:844–865.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Hepatobiliary Cancers (Version 3.2021). 2021.
  • PDQ® Adult Treatment Editorial Board . Adult Primary Liver Cancer Treatment (PDQ­®) – Health Professional Version . Bethesda, MD : National Cancer Institute ; 2019 : https://www.cancer.gov/.

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