MRI-guided stereotactic radiation therapy for hepatocellular carcinoma: a feasible and safe innovative treatment approach

Luca Boldrini, Angela Romano, Silvia Mariani, Davide Cusumano, Francesco Catucci, Lorenzo Placidi, Gian Carlo Mattiucci, Giuditta Chiloiro, Francesco Cellini, Maria Antonietta Gambacorta, Luca Indovina, Vincenzo Valentini

Research output: Contribution to journalArticlepeer-review


Purpose: Hepatocellular carcinoma (HCC) in early stages benefits from local ablative treatments such as radiofrequency ablation (RFA) or transarterial chemoembolization (TACE). In this context, radiotherapy (RT) has shown promising results but has not been thoroughly evaluated. Magnetic resonance-guided RT (MRgRT) may represent a paradigm shifting improvement in stereotactic body radiotherapy (SBRT) for liver tumors. Methods: We retrospectively evaluated HCC patients treated on a hybrid low-tesla MRgRT unit. A total biologically effective dose (BED) > 100 Gy was delivered in 5 consecutive fractions, respecting the appropriate organs-at-risk constraints. Hybrid MR scans were used for treatment planning and cine MR was used for delivery gating. Patients were followed up for toxicity and treatment–response assessment. Results: Ten patients were enrolled, with a total of 12 lesions. All the lesions were irradiated with no interruptions. Six patients had already performed previous local therapies. Median follow-up after SBRT was 6.5 months (1–25). Two cases of acute toxicity were reported (G ≤ 2 according to CTCAE v4.0). At the time of the analysis, 90% of the population presented local control. Child–Pugh before and after treatment remained unchanged in all but one patient. Conclusion: MRgRT is a feasible and safe option showing favorable toxicity profile for HCC treatment.

Original languageEnglish
Pages (from-to)2057-2068
Number of pages12
JournalJournal of Cancer Research and Clinical Oncology
Issue number7
Publication statusPublished - Jul 2021


  • Hepatocellular carcinoma
  • Magnetic resonance-guided radiotherapy
  • Multimodality treatment
  • Radiotherapy
  • Stereotactic body radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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