Stylized liver with glowing pathways and Moscow skyline representing liver cancer treatment in Russia.

Liver Cancer Breakthrough: How New Radiotherapy Techniques are Transforming Treatment in Russia

Rhea Morgan in Health & Wellness November 2025 • 4 min read.

"A survey-based analysis reveals the impact of educational workshops on hepatocellular carcinoma (HCC) treatment and clinical expertise among Russian oncologists."

Hepatocellular carcinoma (HCC), a prevalent and often deadly form of liver cancer, presents a significant challenge worldwide. While radiation therapy (RT) stands as an effective treatment modality, its potential remains largely untapped, particularly in regions like Russia where specific practice patterns have been underexplored.

Recognizing this critical gap in knowledge and the need for enhanced expertise among Russian oncologists, a collaborative team conducted an IRB-approved contouring workshop under the auspices of the Russian Society of Clinical Oncology (RUSSCO). This initiative aimed to evaluate existing clinical experience, identify current patterns of care, and measure the transformative impact of targeted educational interventions.

By analyzing pre- and post-workshop surveys, the study sought to determine the effectiveness of the educational program in improving participants' knowledge base, elevating their comfort levels in managing HCC patients, and ultimately, advancing the standard of liver-directed RT in Russia. The findings provide valuable insights into the current landscape of HCC treatment and the potential for strategic educational initiatives to drive meaningful change.

Unveiling the State of Radiotherapy for HCC in Russia

Stylized liver with glowing pathways and Moscow skyline representing liver cancer treatment in Russia.

The survey results painted a clear picture: HCC presents a significant unmet clinical need in Russia, yet liver-directed RT is underutilized. A significant 60% of respondents had never even evaluated an HCC patient, and a mere 8% had treated one using liver-directed RT. Despite this, a noteworthy 73% expressed initial comfort in offering the therapy, highlighting a potential willingness to adopt new techniques given proper training.

Access to various treatment modalities also varied. While 95% reported access to surgical resection, availability of other options was lower: external beam radiation (77.5%), trans-arterial (chemo)embolization (77.5%), and radiofrequency or microwave ablation (72.5%). Systemic therapy with sorafenib was only available to 32.5% of respondents, and liver transplantation or yttrium-90 microsphere-based radiation therapy were not options for anyone.

Limited Experience: A large percentage of Russian oncologists have limited experience evaluating or treating HCC patients with liver-directed RT.
Uneven Access to Therapies: Availability of various treatment modalities, including advanced options like liver transplantation and Yttrium-90, is inconsistent across different regions.
Geographical Disparities: Access to certain therapies, such as trans-arterial (chemo)embolization, is significantly associated with the practice location, with Moscow-based physicians reporting greater availability.

Motion management is vital for accurate high-dose delivery. Breath-hold was the most common technique (82.5%), while respiratory gating (32.5%), abdominal compression (15%), and tumor tracking (7.5%) were less common. Interestingly, physicians outside Moscow used abdominal compression more often, showing adaptation to resource availability or training differences. There was a knowledge gap concerning HCC diagnosis with 73% initially believing biopsy was always necessary, highlighting a need for education on imaging-based diagnosis in appropriate settings.

Empowering Russian Oncologists: The Path Forward

This research underscores the critical need for ongoing education and training initiatives to empower Russian oncologists with the knowledge and skills necessary to effectively combat HCC. By addressing knowledge gaps, promoting best practices, and fostering collaboration, the medical community can work together to improve outcomes for patients facing this challenging disease. It is recommended to start with a more protracted fractionated RT and building experience through attendance of additional educational activities, participation in multidisciplinary liver tumor boards, and prospective analysis of treatment toxicity and outcomes.

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This article is based on research published under:

DOI-LINK: 10.1007/s13187-018-1447-0, Alternate LINK

Title: Radiotherapy For Hepatocellular Carcinoma In Russia: A Survey-Based Analysis Of Current Practice And The Impact Of An Educational Workshop On Clinical Expertise

Subject: Public Health, Environmental and Occupational Health

Journal: Journal of Cancer Education

Publisher: Springer Science and Business Media LLC

Authors: Timur Mitin, Catherine Degnin, Yiyi Chen, Shervin Shirvani, Erin Gillespie, Sarah Hoffe, Kujtim Latifi, Nima Nabavizadeh, Natalia Dengina, Marina Chernich, Sergey Usychkin, Ekaterina Kharitonova, Yulia Egorova, Alexandr Pankratov, Ilya Tsimafeyeu, Charles R. Thomas, Sergei Tjulandin, Anna Likhacheva

Published: 2018-11-22

Everything You Need To Know

What did the survey reveal about the state of Hepatocellular Carcinoma (HCC) treatment and the use of liver-directed Radiation Therapy (RT) in Russia?

The survey revealed that Hepatocellular Carcinoma (HCC) is a significant unmet clinical need in Russia, with liver-directed Radiation Therapy (RT) being underutilized. A large percentage of oncologists had limited experience with HCC patients and liver-directed RT. Disparities exist in access to therapies like surgical resection, external beam radiation, trans-arterial (chemo)embolization, radiofrequency ablation, systemic therapy with sorafenib, liver transplantation and Yttrium-90 microsphere-based radiation therapy.

What was the purpose of the educational workshops organized in Russia, and how were they structured to improve Hepatocellular Carcinoma (HCC) treatment?

The educational workshops, conducted under the Russian Society of Clinical Oncology (RUSSCO), aimed to evaluate clinical experience, identify care patterns, and measure the impact of educational interventions. The workshops included IRB-approved contouring exercises and pre- and post-workshop surveys to assess improvements in knowledge, comfort levels, and the advancement of liver-directed Radiation Therapy (RT) standards in Russia.

Why is motion management important in liver-directed Radiation Therapy (RT), and what techniques were commonly used in Russia according to the survey?

Motion management during liver-directed Radiation Therapy (RT) is crucial for accurate high-dose delivery. The survey found that breath-hold was the most common technique, while respiratory gating, abdominal compression, and tumor tracking were less common. Interestingly, physicians outside Moscow used abdominal compression more often, suggesting adaptations to resource availability or training differences. The choice of motion management technique impacts the precision of treatment delivery and thus the effectiveness of the Radiation Therapy (RT).

What knowledge gaps were identified among Russian oncologists regarding Hepatocellular Carcinoma (HCC) diagnosis, and why is it important to address these gaps?

Before the workshops, a significant percentage of Russian oncologists believed that biopsy was always necessary for Hepatocellular Carcinoma (HCC) diagnosis. This indicates a knowledge gap regarding imaging-based diagnosis. Addressing this gap is crucial, as relying solely on biopsy can delay treatment and increase patient risk. Education on appropriate imaging techniques can improve the efficiency and safety of Hepatocellular Carcinoma (HCC) diagnosis.

What strategies are recommended to improve outcomes for Hepatocellular Carcinoma (HCC) patients in Russia based on the research findings, and what implications do they have for the field?

The study suggests several strategies to improve outcomes for Hepatocellular Carcinoma (HCC) patients in Russia. These include ongoing education and training for oncologists, promoting best practices, and fostering collaboration within the medical community. Specifically, starting with protracted fractionated Radiation Therapy (RT), attending educational activities, participating in multidisciplinary liver tumor boards, and prospectively analyzing treatment toxicity and outcomes are recommended to enhance expertise and improve patient care. The absence of modalities such as liver transplantation or Yttrium-90 microsphere-based radiation therapy access highlights critical gaps to address.