Asia-Pacific consensus guidelines strongly endorse SBRT for liver cancer

Liver cancer is the third most common cause of death from cancer in the Asia-Pacific region, home to approximately 80% of liver cancer deaths across the globe. Since 2010, an annual scientific conference—the Asia-Pacific Liver Cancer Expert (APPLE) Meeting—has been held to promote the scientific advancement and education in the management of this disease. The program of its 2018 meeting, being held in Seoul, South Korea, in July focuses on the latest treatment techniques and research studies.

Experts attending the 7th annual conference established consensus guidelines on the use of SBRT as a primary treatment for small-sized hepatocellular carcinomas (HCCs), and as a salvage treatment for recurrence. The authors define early state HCC as a solitary tumor ≤ 5 cm in maximum diameter or as 3 or fewer nodules measuring ≤ 3 cm in maximum diameter, without vascular invasion/extrahepatic metastasis and with Child-Pugh A or B hepatic function.

The guidelines encompass indications for SBRT, describe specific techniques, recommended doses, summarize clinical trial therapeutic outcomes, and discuss treatment-related toxicities. The APPLE Association prepared the guidelines because key issues relating to its use are still being investigated, even though SBRT has been used for more than a decade to treat inoperable HCC. They conclude that SBRT offers substantial local control, improved overall survival, and low toxicity.


Zeng ZC, Seong J, Yoon SM, et al. Concensus on Stereotactic Body Radiation Therapy for Small-Sized Heaptic Carcinoma at the 7th Asia-Pacific Primary Liver Cancer Expert Meeting. Liver Cancer 2017 6:264-274.

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Asia-Pacific consensus guidelines strongly endorse SBRT for liver cancer.  Appl Rad Oncol. 

By Cynthia E. Keen| March 20, 2018

About the Author

Cynthia E. Keen

Cynthia E. Keen

Cynthia E. Keen is a medical writer and regular contributor to Applied Radiation Oncology. She is based in Sanibel Island, Florida.


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