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Radiation Therapy for Liver Cancer

Radiation therapy uses high-energy rays (or particles) to kill cancer cells. It may not be a good option for some patients whose liver has been greatly damaged by diseases such as hepatitis or cirrhosis.

Radiation can be helpful in treating:

  • Liver cancer that cannot be removed by surgery
  • Liver cancer that cannot be treated with ablation or embolization or did not respond well to those treatments
  • Liver cancer that has spread to other areas such as the brain or bones
  • People with pain because of large liver cancers
  • People with a tumor thrombus (a collection of liver cancer cells) blocking the portal vein.

How is radiation therapy given?

External beam radiation therapy (EBRT) focuses radiation from a source outside of the body on the cancer. Getting radiation therapy is much like getting an x-ray, but the radiation is stronger. The procedure itself is painless. Each treatment lasts only a few minutes, although the setup time – getting you into place for treatment – usually takes longer. Most often, EBRT treatments are small doses of radiation given 5 days a week for several weeks.

Although liver cancer cells are sensitive to radiation, much care is taken when planning the treatment to avoid damaging normal liver tissue as much as possible. Newer radiation techniques, such as stereotactic body radiation therapy (SBRT), help doctors target liver tumors while reducing the radiation to nearby healthy tissues. This makes it more effective and reduces side effects. SBRT allows treatment to be completed in a short-time compared to EBRT. It uses very focused beams of high-dose radiation given on one or a few days. Beams are aimed at the tumor from many different angles. To focus the radiation precisely, the person is put in a specially designed body frame for each treatment. This type of radiation may be used in people with small cancers who are waiting for a liver transplant.


As mentioned in Embolization Therapy for Liver Cancer, tumors in the liver can be treated by injecting small radioactive beads into the hepatic artery. The beads then lodge in the liver near the tumor and give off small amounts of radiation that travel only a short distance.

Possible side effects of radiation therapy for liver cancer

Some of the more common side effects of radiation therapy include:

  • Skin changes in areas getting radiation, ranging from redness to blistering and peeling
  • Nausea and vomiting
  • Fatigue
  • Diarrhea
  • Loss of appetite

These effects typically go away within a few weeks after treatment ends.

A more serious side effect of radiation therapy to the liver is radiation-induced liver disease (RILD). It commonly happens 3 to 4 months after treatment and usually only lasts a set time, but can be fatal in some instances. Signs and symptoms seen with RILD can include abnormal blood liver tests, an enlarged liver and spleen, ascites (fluid build up in the abdomen), and jaundice. Ask your doctor what side effects to expect and how to prevent or relieve them.

More information about radiation therapy

To learn more about how radiation is used to treat cancer, see Radiation Therapy.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Abou-Alfa GK, Jarnigan W, Dika IE, D’Angelica M, Lowery M, Brown K, et al. Ch. 77 - Liver and Bile Duct Cancer. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020:1314–1341.

Fong Y, Dupey DE, Feng M, Abou-Alfa G. Ch. 57 - Cancer of the Liver. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019:844-864.

National Cancer Institute. Physician Data Query (PDQ). Adult Primary Liver Cancer Treatment. Accessed at on March 7, 2019.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Hepatobiliary Cancers. V.1.2019. Accessed at on March 7, 2019.

Last Revised: April 1, 2019

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