Would you consider SBRT for a patient with a solitary HCC lesion, with SLE/lupus previously on immunosuppression?

This one is a little bit tough, because there are other treatments for a solitary HCC lesion (surgery, TACE, RFA...), it may be better to use those options and avoid the risk of potentially enhanced toxicity. However, I suspect the risk is not very large as the risk from SBRT to the liver is so smal...

I personally cannot recall ever treating a patient with HCC and SLE. I would use the same general clinical gestalt to counsel patients that we do with other patients with SLE than need radiation.

What I can comment on is SBRT to the liver in the context of immunosuppression which we have done a lot...

Yes. Would not alter the treatment plan specifically based on autoimmunity or immunosuppression (which can be radiosensitizing) but would focus on high quality plan minimizing normal tissue irradiated. Toxicity is volume dependent. Have treated liver transplant patients with colorectal metastasis in...