Procedure
Radiation therapy focuses high-energy X-rays on the tumor inside the body to specifically kill it. It is carried out as an outpatient treatment, is non-invasive (i.e. does not require anesthesia) and can therefore be easily integrated into everyday private life. Depending on the size of the tumor, radiation therapy for small tumor sites can be administered in just a few treatment sessions as stereotactic body radiation therapy (SBRT), or as a fractionated treatment over several weeks following surgery. Close and personal support is a matter of course for us.
At the USZ’s Department of Radiation Oncology, only the most advanced techniques are used to provide the most precise and side-effect-free radiation treatment for liver cancer. You will be cared for by senior physicians who are experienced in the treatment of liver cancer.
We work closely with our colleagues in surgery and medical oncology to guarantee treatment from a single source.
For many patients, we are already offering tomorrow’s treatment today: in clinical trials, we are continuously working on improving the treatment of liver cancer to make it even more effective and tolerable. To the overview of currently open studies.
In the following, we will describe radiation therapy for the various types and stages of liver cancer.
Irradiation of liver cancer with the aim of local control
For locally confined liver cancer, surgical resection or liver transplantation is the treatment of choice. However, if the cancer cannot be treated with surgery, or if surgery or a liver transplant is not (yet) possible at this time, radiation therapy is a good option for slowing or stopping the growth of the cancer. Radiation therapy (also known as radiotherapy) is used particularly frequently in this case when the cancer is located near major blood vessels, the main bile ducts, or the diaphragm, or when it is larger than 3 cm.
We use a technique known as stereotactic body radiation therapy (SBRT). This kills the tumor in very few radiation sessions: typically in 5 outpatient radiation sessions. This is achieved by highly focused irradiation with an accuracy in the millimeter range. Whenever possible, this treatment is performed using our specialized device, the MR-LINAC, which combines MRI imaging and radiation therapy. The integrated MRI provides a highly detailed image the actual anatomy. The position of the tumor and the surrounding healthy organs can thus be determined with millimeter precision every day and the radiation can – if necessary – be optimally adapted to the current situation immediately. In addition, MRI technology allows us to monitor tumor and organ movement “live” during radiation therapy. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.
Stereotactic body radiation therapy (SBRT) is a key clinical and scientific focus of our clinic. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions. State-of-the-art equipment and experienced medical physicists and medical technologists contribute to treatment of the highest quality and safety.
Liver cancer before surgery
If the tumor has grown into specific liver vessels and has blocked them, radiotherapy can be used upstream with the aim of facilitating the subsequent operation. In these cases, radiotherapy is carried out in six sessions over a period of just over a week.
Metastases of liver cancer, e.g. in the brain or bones
Liver cancer is an aggressive form of cancer that often spreads to other parts of the body as the disease progresses; this is called metastasis. Common sites of metastasis are the lung, adrenal gland, bones, liver or brain. Radiotherapy is a highly effective method with few side effects to prevent or treat symptoms caused by metastases. This is usually done in combination with chemotherapy, immunotherapy or other targeted therapy. The smaller the metastases are and the earlier they are irradiated, the better the results. Today, metastases in the body can be treated in a focused manner in just a few effective radiation sessions.
For tumor foci in the abdominal area, e.g. liver or upper abdomen, we carry out body stereotactic radiotherapy (SBRT) on our MRI hybrid accelerator. State-of-the-art radiation technology is combined with MRI images. The radiation is thus carried out under MRI monitoring of the tumor, so that the highest precision is combined with the best imaging. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.
Today, brain metastases are treated at our center in most patients by means of a single high-dose radiation treatment: this is called radiosurgery. Metastases at other locations in the body can now also be treated in a focused manner in just a few effective radiation sessions. Metastatic liver cancer is a clinical and scientific focus of our clinic. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions.
State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety. At the same time, we work closely with our colleagues in medical oncology to guarantee “one-stop” treatment. We also consult with our colleagues in palliative medicine at an early stage.
In clinical trials, we are continuously trying to improve the treatment of liver cancer in order to make it even more effective and tolerable. To the overview of currently open studies.