Abstract: In the past decade with the popularization of image guide radiotherapy, stereotactic radiotherapy (SRT) of primary liver cancer has been widely used and gained a lot of clinical experience. A gratifying course of development includes the experience from case reports or unique center retrospective clinical study to multiple center prospective clinical studies. The evidence based medicine of SRT gradually upgraded. Previous reports about SRT for patients with primary liver cancer focused on those with recurrence or metastatic disease or refractoriness which are poor prognosis in comparison with those with initial therapy with SRT. Study on the patients with primary liver cancer treated with SRT or surgical resection for intrahepatic lesions in the same period, the results showed that similar overall survival and local control rates after propensity score matching in the 2 groups. However, the toxicity is milder in the patients treated with SRT in comparison with surgical resection. Relapse or metastatic primary liver cancer is easy to recur or metastasize, so it is necessary to treat those patients using combination with both SRT and anti-programmed death-1 (PD-1) antibody. The primary results showed that SRT combination with immunotherapy has much better overall survival and progress free survival. The results indicate that it is worthy of further exploration in the future.

Key words: Primary liver cancer, Stereotactic radiotherapy, Progress