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Examining Standard Radiation Treatments for the Long-Term Management of HCC

Emil I. Cohen, MD
Published Online:7:07 PM, Fri August 9, 2019

The research around best radiation-based treatment options for patients with hepatocellular carcinoma (HCC) are over 15 years old, but the standard of care for long-term management of the disease is still conventional chemoembolization, according to Emil I. Cohen, MD, assistant professor, Georgetown University Hospital.
Since the original data were released demonstrating a benefit in progression-free survival with chemoembolization, other studies have excluded patients who are transplant candidates. This is because physicians are more careful with these patients to ensure they continue to meet the criteria for transplantation, says Cohen. However, patients who are ineligible for a transplant have been enrolled in studies comparing radioembolization with conventional chemoembolization as a potential bridge to transplantation.
Another promising treatment option for long-term management of HCC is external beam radiation, Cohen says. Some patients cannot receive the standard of care and should be referred to a radiation oncologist for this option. Based on recent findings, combining external beam radiation with chemoembolization can even improve progression-free survival and decrease the chances of recurrence. Cohen notes, however, that more data are required to fully recommend external beam radiation as a standard of care.
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