**3. Overall survival**

Overall survival is around 66.7% at 3 years [40]. In the study by Méndez Romero et al, overall survival at 1 year was 75%18 and in the study by Bujold et al, 55% (24–54 Gy in six fractions) [12]. And in the study by Su et al, overall survival at 1 year was 94%20. Kang et al reported an OS at 2 years after SBRT (42–60 Gy in three fractions) of 69% [6]. In the study by Sanuki et al, overall survival at 3 years was 70%, with no difference between doses of 35 and 40 Gy [9]. Overall survival at 1, 2, and 3 years in the study by Rim et al. was 72.6, 57.8, and 48.3%, respectively [29].

When the intention of the treatment is neoadjuvant, the aim is to prevent progression of patients on the waiting list for liver transplantation and to prevent them from leaving the waiting list. SBRT is an effective treatment as a bridge to transplantation. One study retrospectively included 10 patients with hepatocellular carcinoma on the transplant list treated with SBRT. Two patients had Child Pugh B and one had Child Pugh C, the median tumor size was 3.4 cm (2.5–5.5 cm), and the median dose was 51 Gy in 3 fractions. Four patients had received previous treatment with TACE. All patients were successfully transplanted. On anatomic-pathologic review, three patients had complete response and three patients had minimal remainder. The 5-year overall survival and progression-free survival were 100%, and there were no toxicities greater than or equal to grade 3 [41]. Mannina et al analyzed their experience using SBRT in 38 patients with hepatocellular carcinoma, and all patients were transplanted [40]. Complete response was observed in 45% of lesions and partial response in 23%, with poor concordance between radiological and pathological evaluation. Overall survival at 1, 2, 3, and 5 years was 92, 86, 77, and 73%, respectively [42].
