TACE With or Without SBRT as Bridging Therapy for Pre-transplant HCC Patients

Inclusion Criteria:

• Patient capable of giving informed consent

• Patient diagnosed with hepatocellular carcinoma and listed or recommended to belisted for orthotopic liver transplantation at the participating institution

• Age > 18 years old

• Meets clinical criteria for eligibility for TACE to the target lesion perInterventional Radiology

• Childs' Class A or B7

• Eastern Clinical Oncology Group performance status 0 or 1

Exclusion Criteria:

• Prior radiotherapy to the upper abdomen or radioembolization of the liver

• Prior TACE to the target lesion, RFA, or liver transplant

• Active GI bleed within 2 weeks of study enrollment

• Active GI ulcer disease within 4 weeks of study enrollment

• Ascites refractory to medical therapy

• Contraindication to receiving radiotherapy or TACE

• Complete obstruction of portal venous flow to the segment of liver that includes thetarget lesion

• Contraindication to both contrast enhanced MRI and contrast enhanced CT (i.e. unableto undergo follow-up imaging or SBRT treatment planning)

• Women who are pregnant

• Participation in another concurrent treatment protocol