TACE Plus Radiotherapy Raises 5-Year Liver Cancer Survival to 76%

Early Liver Cancer Treatment Is Changing: Longer Survival with Combined Therapy

Hepatocellular carcinoma (HCC), arising from the liver's own tissue, is among the leading causes of cancer death worldwide. Early-stage disease can be cured with surgery or transplantation. Unfortunately, many patients are ineligible because of tumor location, overall liver condition or comorbidities.

For these patients, the longstanding standard has been delivering chemotherapy into the tumor-feeding vessel and then blocking it: TACE (Transarterial Chemoembolization) . TACE is effective, but alone completely eliminates tumors in only around 40-60%, and recurrence may occur.

Published on 9 December 2025 in the International Journal of Radiation Oncology, Biology, Physics , a large South Korean study involving over 1200 patients challenges existing practice. Researchers demonstrated that adding early radiotherapy to TACE substantially extended survival and time without cancer. This article explains who benefits most from this double-strike approach and how planning may change.

Study Scope: A Large Analysis of 1200 Patients

The study examined data from patients with early-stage (BCLC 0-A), single-nodule liver cancer who were ineligible for surgery: 1243 patients divided into two main treatment groups.

• Group 1 (Combined Treatment): 257 received radiotherapy in addition to TACE; 80% of radiation treatments were pinpoint SBRT.
• Group 2 (Standard Treatment): 986 received TACE alone.

Results: Clear Superiority of Combined Treatment

After a median 52-month follow-up, combined TACE + radiotherapy was substantially more successful than TACE alone.

The Keys to Success: Who and When?

The study explains not only whether to give radiotherapy, but how to use it most effectively.

• 1. Early Treatment Saves Lives: Radiotherapy delivered after TACE within the first 90 days multiplies success: 5-year survival was 84.3% with early radiotherapy versus 68.5% with later treatment.
• 2. Who Benefits Most? The combination makes a particular difference in patients with high-risk features. Radiotherapy should be considered if one or more of these 3 features are present:
  • Tumor diameter greater than 4 cm,
  • AFP above 100 ng/mL,
  • Incomplete tumor response to the first TACE procedure.