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Role of Radiation Therapy in Multidisciplinary Management of Hepatocellullar Carcinoma Darlene Gabeau, M.D., Ph.D. Assistant Professor Department of Radiation Oncology Department of Radiation Oncology

HCC : Standard Treatment Algorithm Barcelona Clinic Liver Cancer System Llovet, J. M. et al. J. Natl. Cancer Inst. 2008 100:698-711

HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25%

HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25% Survival 50 - 80%

HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25% Survival 50 - 80% Ablation Survival 10 - 50%

HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25% Survival 50 - 80% Ablation Survival 10 - 50% TACE Survival 30 - 60%

[object Object],[object Object],HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25% Survival 50 - 80% Ablation Survival 10 - 50% TACE Survival 30 - 60%

[object Object],[object Object],HCC: Limitations of Standard Modalities Survival 50 - 70% Local Control <25% Survival 50 - 80% Ablation Survival 10 - 50% TACE Survival 30 - 60% ,[object Object],[object Object],[object Object]

Radiation Therapy: Important therapeutic modality ,[object Object],[object Object],[object Object]

Radiation Therapy: Important therapeutic modality ,[object Object],DNA repair Cell cycle regulation Apoptosis

Radiation Therapy: Important therapeutic modality ,[object Object],[object Object]

Radiation Therapy: Important therapeutic modality ,[object Object],[object Object],[object Object],Repair Normal Tissue > tumor Repopulation Normal Tissue, Some tumors Redistribution Not significant Reoxygenation Tumors

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Radiation Therapy: Important therapeutic modality

Radiation Therapy: Important therapeutic modality ,[object Object],[object Object],[object Object],[object Object],[object Object],TV IV Less conformal More conformal TV

Emerging Role for Radiation Therapy in HCC: Why not in intra-hepatic malignancies? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Emerging Role for Radiation Therapy in HCC ,[object Object]

Emerging Role for Radiation Therapy in HCC: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Emerging Role for Radiation Therapy in HCC: Dependent on Advances in imaging ,[object Object],[object Object],[object Object],[object Object]

Emerging Role for Radiation Therapy in HCC: Stereotactic Body Radiotherapy (SBRT) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Experimental Questions

[object Object],[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Experimental Questions

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Experimental Questions

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Experimental Questions

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Montefiore-Einstein Liver SBRT Pilot Project

[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Montefiore-Einstein Liver SBRT Pilot Project

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Emerging Role for Radiation Therapy in HCC: Potential Future Directions

Multidisciplinary Team ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Hepatology Paul Gaglio John Reinus Pathology Quiang Lu Kathryn Tanaka Surgery Milan Kinkhabwala Funding: Paul Calabresi Award in Clinical Oncology (K12) Prinicipal Investigator: Roman Perez-Soler

02.3 gabeau mac

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