Abstract
Hepatocellularcarcinoma(HCC)isconsideredasanaggressivelivertumorwithapoor5-yearsurvivalrate.ManyHCCsarenotamenabletosurgicalresection,becauseoftumorsize,locationorduetounderlyingpoorliverfunctionbecauseHCCalmostalwaysdevelopinchronicallyinflamedlivers.Dependingontheextentofdiseaseandcomorbidities,multipleliver-directedtherapy(LDT)optionsexistforthetreatmentofHCC.Historically,theuseofexternal-beamradiotherapy(EBRT)forHCCbeenlimitedbytoxicitytotheuninvolvedliverandsurroundingstructures.AdvancesinRThaveimproveddoseconformitytothetumorandfacilitateddoseescalation,akeycontributortoimprovedHCCradiationtreatmentoutcomes.Theseadvancementsinradiationoncologyhaveledtotheemergenceofstereotacticbodyradiationtherapy(SBRT)asapromisingLDT,whichdelivershighdosesofradiationwithasteepdosegradienttomaximizelocaltumorcontrolandminimizeradiation-inducedtreatmenttoxicity.ThisreviewwillenlightentheprimaryphysiciansandoncologycareprovidersaboutthepromisingandevolvingroleofRTinvariousstagesofHCC