Precise stereotactic body radiotherapy (SBRT) treats liver tumours with high accuracy — without surgery, incisions, or prolonged hospital stays.
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Early and precise treatment of liver tumours is critical.
Frameless SBRT delivers high-dose, targeted radiation with sub-millimetre accuracy, treating liver tumours effectively while preserving healthy liver tissue and avoiding invasive surgical risks.
Liver SBRT is a highly precise, non-invasive radiation therapy that targets liver tumours accurately while minimising exposure to healthy liver tissue. It is an effective option for selected patients, including those who are not suitable for surgery.
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Liver SBRT may be used to treat selected liver conditions, including primary liver cancer (hepatocellular carcinoma), liver metastases from other cancers, and bile duct cancers (cholangiocarcinoma), depending on tumour characteristics and liver function.
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Quality liver SBRT depends on accurate radiation dosing, effective management of liver movement during breathing, and treatment delivered by an experienced, multidisciplinary stereotactic radiotherapy team with specialised expertise in liver tumours.
Book An AppointmentThe Liver SBRT programme at AARO was initiated by our doctors during their time at the National Cancer Centre and has since been expanded to benefit patients in the private sector.
The programme is built on established protocols developed in collaboration with leading international cancer institutions, supported by continuous education and training. Through this programme, patients with conditions such as primary liver cancer (HCC), liver metastases, and selected cases of cholangiocarcinoma have benefited from precise, multidisciplinary liver SBRT care.
We offer a range of non-surgical, liver-directed therapies tailored to the stage and characteristics of each tumour. All treatments are planned and delivered by a multidisciplinary team to maximise tumour control while preserving healthy liver function.
Radiofrequency ablation (RFA) is a minimally invasive procedure used to destroy abnormal tissues. It involves inserting a needle-like probe into the target tissue, which then emits high-frequency electrical currents. These currents generate heat, causing thermal damage and leading to cell death in the affected area. RFA is commonly used in the treatment of liver, kidney, lung and bone tumours.
Microwave ablation (MVA) is another minimally invasive technique used to treat tumours by generating heat to destroy cancer cells. Unlike RFA, MVA uses electromagnetic waves in the microwave spectrum to heat and ablate the tissue. This method is typically faster and can treat larger tumours than RFA. The procedure involves inserting a microwave antenna into the tumour under imaging guidance, allowing precise delivery of treatment.
Liver SBRT is a highly precise form of radiation therapy used to treat liver tumours. It involves delivering high doses of radiation to the tumour site while minimising exposure to surrounding healthy tissue.
Proton beam therapy (PBT) is an advanced form of radiation therapy that uses protons instead of traditional X-rays to treat cancer. Protons deposit most of their energy at a specific depth, known as the Bragg peak, allowing for more precise targeting of tumours with minimal damage to surrounding healthy tissue. This makes PBT particularly beneficial for tumours located near critical structures.
TACE is a targeted treatment for liver cancer that combines chemotherapy with embolisation. The procedure involves delivering chemotherapy drugs directly to the tumour through the hepatic artery, followed by the injection of embolic agents that block the blood supply to the tumour. This dual action helps enhance the efficacy of the chemotherapy and limit systemic side effects. TACE is mainly used for hepatocellular carcinoma (HCC) and can be repeated if necessary.
SIRT, also known as radioembolisation, involves injecting tiny radioactive beads (microspheres) into the hepatic artery. These beads lodge in the tumour's blood vessels and deliver high doses of radiation directly to the cancer cells while sparing most of the surrounding healthy liver tissue. SIRT is often used for inoperable liver tumours, including primary liver cancer and metastatic cancer to the liver.
Director, Senior Consultant Radiation Oncologist
MBBS (SIN), FRCR (Clinical Oncology, UK), FAMS (Radiation Oncology), MBA (Healthcare Management)
Dr Tan brings over 20 years of cancer care experience and was formerly a Consultant Radiation Oncologist at the National Cancer Centre Singapore (NCCS). He pioneered Southeast Asia's first advanced Spine, Prostate, and Liver SRS/SBRT programs, and in 2024 was elected to the Board of Directors of the International Stereotactic Radiosurgery Society (ISRS). He continues to advance innovative, patient-focused cancer treatments.
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Medical Director (AARO), Senior Consultant Radiation Oncologist
MBBS (SIN), FRCR (Clinical Oncology, UK), FAMS (Radiation Oncology)
With over 15 years of cancer care experience, Dr Tan is a leading expert in stereotactic radiotherapy. Formerly at the National Cancer Centre Singapore, he helped establish advanced SBRT programs for liver and pancreas cancers. He is dedicated to delivering precise treatment with compassionate care.
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Medical Director (CSR), Senior Consultant Radiation Oncologist
MBBS (SIN), FRCR (Clinical Oncology, UK), FAMS (Radiation Oncology)
With over 20 years in cancer care, Dr Teh previously served as Consultant Radiation Oncologist at the National Cancer Centre Singapore (NCCS). He led Southeast Asia's first clinical trial on Prostate SBRT and co-authored the landmark study on its safety and efficacy in Singapore. A recognised leader in prostate cancer treatment, he is committed to delivering precise and compassionate care.
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SBRT has shown strong results in treating both primary and secondary liver tumours, achieving better tumour control than conventional radiation therapy delivered over several weeks.
In a study of 102 patients with hepatocellular carcinoma, 87% maintained tumour control at one year after SBRT, even though more than half had tumours involving major liver veins — a situation that often limits treatment options.
For secondary liver tumours, SBRT has also demonstrated excellent outcomes, with local control rates of 70–100% at one year and 60–90% at two years.
The early side effects of SBRT to the liver include fatigue, nausea (rarely vomiting) and mild skin changes. These are temporary and resolve within a month of radiation therapy.
Normal liver cells can be damaged by radiotherapy, with the effects seen only a few weeks after SBRT. With attention to technique in avoiding as much normal liver as possible, this usually shows up as mild to moderate abnormalities in the liver blood tests without any symptoms. The blood tests tend to normalise with time.
For patients with an underlying unhealthy liver, there is a higher risk of radiation-induced liver disease severe enough to cause liver failure. Patient selection is therefore very important.
SBRT to the liver is not for all patients with liver tumours. Sometimes surgery or chemotherapy may be more suitable.
Even when radiotherapy is the preferred option, the tumour may be too close to critical organs or the liver too unhealthy for high dose SBRT to be performed, in which case lower doses of conventional radiotherapy may have to be used.
It is therefore vital that all patients considering liver SBRT be assessed by a radiation oncologist with experience and expertise in liver SBRT, before embarking on this advanced treatment.
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