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What is the role of liver SBRT in the setting of an excellent interventional radiology program?

Our hospital has an aggressive and talented interventional radiology group. We have wanted to start a stereotactic liver radiotherapy program but are assured that there is no place for SBRT as they can do everything. To their credit, they routinely perform selective embolization, Y 90, RF and microwave. Criticisms of SBRT are that they can easily treat dome lesions, and that explant series demonstrate a substantial and greater persistence of disease after SBRT than after RF or microwave. Additionally, stereotactic radiation may convert Childs A patients to Childs B and C patients. From my understanding of the literature, stereotactic radiation is complementary and effective even for a talented interventional program, and especially worthwhile in tumors near the hilum, as well as dome lesions and lesions more than 3-4 cm, although it needs to be applied carefully. I’d like to solicit opinions on this topic as well as recent current literature, if it exists, that demonstrates where we may provide benefit with stereotactic RT.
3 Answers
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Radiation Oncology · Cleveland Clinic
Answered on

An excellent question, there is certainly a significant role for a liver SBRT program in the setting of an excellent and talented interventional radiology group. The important hurdle that must be overcome for this to take hold is for everyone to view this as a collaboration rather than a competition...

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Radiation Oncology · Memorial Sloan-Kettering Cancer Center
Answered on · Updated on

Do you mean interventional oncology program? Remember that interventional radiology has re-branded themselves as interventional oncology. I agree that the best way to build a program is to show up consistently at the multidisciplinary conference, interact with your colleagues and challenge them publ...

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Radiation Oncology · Rush University
Answered on

Agree with all of the above - SBRT should optimally be used​ to augment (not replace) existing treatment strategies in a healthy locoregional therapy program. In the context of a planned transplant it is important to remember that TACE is primarily used as a bridging therapy. Median time to local ...

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