What is the role of radiation therapy in treating liver tumors?

Alex Cruz, Michael D Chuong, Ravi Shridhar and Sarah E Hoffe*

With the liver’s dual blood supply and the preferential tumor vasculature from the hepatic artery, liver malignancies offer unique challenges and opportunities for treatment. In the case of primary liver tumors, such as hepatocellular carcinoma and cholangiocarcinoma, the disease burden, when diagnosed, is often extensive and precludes other local forms of therapy. External beam radiation therapy and intravascular brachytherapy, or radioembolization, have been shown to improve outcomes in these patients. Even though many will respond to radiation therapy, long-term cure is unlikely unless they ultimately proceed to resection or transplant. Oligometastases can also be effectively treated with radiation therapy. This review will explore the potential for radiation therapy options to be considered for both primary and metastatic liver malignancies.