Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma in Child-Pugh Class C As Bridge Therapy Before Liver Transplantation

Hepatocellular carcinoma (HCC) is a rising global health concern, frequently developing in patients with cirrhosis. Stereotactic body radiotherapy (SBRT) offers an effective treatment option for localized HCC, utilizing advanced imaging and planning technologies to accurately target tumors while sparing healthy tissues. It serves as an alternative when other locoregional therapies are contraindicated. We present the case of a 58-year-old male with HCC exceeding 5 cm and classified as Child-Pugh Class C. Following a failed attempt at transarterial chemoembolization (TACE) due to deteriorating liver function, SBRT was selected as an alternative bridging therapy. The patient received a total dose of 30 Gy in five fractions. Throughout the treatment, he experienced no significant toxicity, and post-SBRT imaging indicated gradual tumor regression. Seven months post-SBRT, the patient successfully underwent deceased-donor liver transplantation. Pathological examination of the explanted liver revealed necrotic nodules, indicating a positive response to SBRT.