Carbon ion radiotherapy of hepatocellular carcinoma provides excellent local control: The prospective phase I PROMETHEUS trial.

10 SBRT showed a trend towards better PFS and LC compared with TACE. 11 In retrospective studies, LC after SBRT was comparable to RFA 12 and superior to TACE. 13 Although techniques such as RFA and MWA are only applied to lesions up to 5 cm, 3 , 4 , 14 the feasibility and safety of SBRT have been demonstrated for median lesion diameters of 7–8 cm. 15 Furthermore, vessel proximity or venous thrombosis play less of a role for SBRT eligibility. 2 , 12 , 16 HCC mainly occurs in pre-damaged, cirrhotic, steatotic, or infected livers.

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