Medical Oncologist
CION Cancer Clinics
How many sessions of SBRT will my liver tumour need? | CION Cancer Clinics
Most people having SBRT for a liver tumour have three to five sessions, on separate days over one to two weeks. The exact number is set by your radiation oncologist after the planning scan, based on where the tumour sits and how well your liver works. This page explains what decides the number, what happens between visits, and who this treatment does not suit. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- How many SBRT sessions does a liver tumour usually need?
- Why one person gets three sessions and another gets five
- What happens between the decision and the final session?
- The words on a radiation plan, in plain language
- What families often assume about the number of sessions
- Who SBRT does not suit, and what this page cannot tell you
- Common questions about liver SBRT sessions
The short answer
How many SBRT sessions does a liver tumour usually need?
Most people having SBRT for a liver tumour have between three and five sessions, given on separate days over one to two working weeks. A few have a single session, and some have more, when the tumour sits close to the bowel or the liver is already weak.
SBRT stands for stereotactic body radiation therapy. It means a high dose of radiation aimed very precisely at a small target, split into a handful of visits instead of the many short daily visits of ordinary radiation. Each visit is called a fraction. The number of fractions is not a measure of how serious the cancer is. It is a safety choice made by your radiation oncologist after the plan has been drawn on your own scan.
Who this page is about
This page is mostly for people with a primary liver cancer (hepatocellular carcinoma, or HCC) and for people with a few small spots that have spread to the liver from another cancer. If your liver spots came from bowel cancer, the colon cancer pages cover that plan. How the radiation itself works is explained on SBRT for liver tumours.
Fewer sessions does not mean weaker treatment. The total dose is planned to do the same job.What sets the number
Why one person gets three sessions and another gets five
The team splits the dose to protect what sits around the tumour. Four things drive that choice.
Where the tumour sits
A tumour deep inside the liver, away from other organs, can often take a larger dose at each visit. A tumour pressed against the stomach, the bowel or the main bile ducts usually needs the dose spread more thinly over more visits, because those organs are less forgiving.
How well the liver works
A liver with cirrhosis has less spare capacity. Your team checks the Child-Pugh score, a grade of liver function from blood tests and examination, before planning. A weaker liver often means a gentler dose per visit and closer monitoring.
The size and number of spots
A larger tumour, or two separate spots, puts more healthy liver in the path of the beams. Splitting the dose over more sessions lets that healthy tissue recover between visits.
Earlier treatment to the same area
If you have had TACE, ablation or radiation near the same spot before, the plan accounts for it. Repeat treatment is often split into more sessions.
Also weighed
- How well you can lie still and hold your breath
- How the tumour moves when you breathe
- Whether other treatment is planned alongside
Not sure whether this applies to you?
Ask an oncologistFrom referral to last visit
What happens between the decision and the final session?
The tumour board decision
The liver tumour board reviews your scans and blood tests and agrees that radiation is the right choice over ablation, TACE or surgery.
Markers and the planning scan
Some people first have tiny gold markers placed near the tumour so it can be seen during treatment. Then a planning CT, sometimes with an MRI, is done in the exact position you will lie in.
The plan is drawn
The radiation oncologist and physicist draw the target and the organs to protect. This is the point when the number of sessions is fixed. It usually takes several working days.
The sessions themselves
Each visit takes longer than ordinary radiation because of the careful setup and imaging. Sessions are usually given every other day, or on consecutive weekdays, at a partner radiation centre.
On your plan
The words on a radiation plan, in plain language
- Fraction
- One treatment visit. Five fractions means five visits on five different days.
- Total dose
- All the radiation added together across every fraction, measured in a unit called gray. It is the figure your oncologist cares about most.
- Dose per fraction
- How much is given at each visit. Fewer sessions means a larger dose each time.
- Simulation
- The planning appointment, where the scan is taken and a mould or cushion is made to hold you in the same position every day.
- Image guidance
- A quick scan on the treatment machine before each session, to check the tumour is exactly where the plan expects it.
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Commonly believed
What families often assume about the number of sessions
"More sessions must mean the cancer is worse."
The number reflects safety, not severity. A small tumour beside the bowel may need more sessions than a larger one in the middle of the liver, because the bowel needs protecting.
"If we miss a session, we can just add one at the end."
The gaps are part of the plan. If you must miss a visit because of illness or travel, tell the team at once. They decide how to adjust, and it is not always as simple as adding a day.
"One big session would be quicker and just as good."
For some tumours a single session is used. For many liver tumours, packing everything into one visit would put too much strain on the liver or the organs nearby.
"We should come from the district and stay in Hyderabad for a month."
SBRT is short. Once the plan is ready, most families need to stay only for the treatment visits themselves. Ask for the full calendar before booking a long stay.
Being straight with you
Who SBRT does not suit, and what this page cannot tell you
SBRT is not for everyone with liver cancer. It is usually not offered when the tumour is very large, when there are many spots spread through the liver, when the liver is failing, or when the cancer has spread widely outside the liver. In those situations the tumour board usually looks at TACE, Y-90 or systemic treatment instead. People who cannot lie flat or keep still for a long session may also not suit it.
It cannot give you your number
Only your radiation oncologist can say how many sessions you need, and only after the planning scan. Two people with the same stage can be given different numbers for good reasons.
Who to ask
CION's medical oncologists and tumour board decide whether radiation fits your liver cancer, and CION coordinates SBRT through accredited partner radiation centres. If you already have a plan and want it checked, a second opinion is a reasonable step.
Bring your latest scans, blood reports and any earlier treatment summaries to the consultation.Questions we are asked
Common questions about liver SBRT sessions
How long does each SBRT session take?
Longer than people expect. Most of the time goes on positioning you and taking a check scan, not on the radiation itself. Allow for most of a morning or afternoon at the centre on each treatment day. The team will give you a clearer estimate once your plan is ready.
Are the sessions given every day?
Usually not quite. Many centres give liver SBRT every other weekday so the healthy liver can recover between visits. Some give it on consecutive days. Your calendar will be set when the plan is approved, so ask for it in writing before you make travel plans.
Will I need to stay in hospital?
Most people go home after each session. SBRT does not need an anaesthetic or a cut. Families travelling from a district often stay nearby for the short treatment period and return home once the last session is done.
Does it hurt during the session?
The radiation itself cannot be felt. The harder part is lying still with your arms above your head for a long time. Tell the team if your back or shoulders ache, because they can often adjust the cushions or give you something for the discomfort beforehand.
What side effects can I expect between sessions?
Tiredness and mild nausea are the most common. Some people feel a dull ache over the liver. Tell the team about fever, yellowing of the eyes, a swelling tummy or new confusion straight away, because these can be signs the liver is under strain.
Can the number of sessions change once treatment starts?
Rarely, but it can. If your blood tests change sharply, or the check scan shows something unexpected, the oncologist may pause or adjust the plan. You will be told why, and the new plan will be explained before you continue.
How soon will we know if it worked?
Not straight away. The tumour keeps changing for some time after the last session. The first check scan is usually a few months later, and a scan taken too early can look confusing. Your team will tell you when the follow-up scan is due.
Does the number of sessions change the cost?
It can, along with the planning scans, markers and the centre itself. The liver radiation cost page explains what moves the bill. Ask the partner centre for a written, itemised estimate before treatment begins.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- American Cancer Society — Radiation Therapy for Liver Cancer
- National Cancer Institute — Radiation Therapy for Cancer
- EASL — EASL Clinical Practice Guidelines: management of hepatocellular carcinoma
- Cancer Research UK — Treatment for liver cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
SBRT for liver tumours: who it suitsCheck whether you are a candidate at allBreathing control for liver radiationWhat you will be asked to do on the tableWill radiation damage my liver?The question most people with cirrhosis ask nextSBRT vs ablation for a small liver tumourHow the team chooses between the two
Talk to us
Has radiation been suggested for a liver tumour?
Our oncologists can review your scans and blood reports and explain whether SBRT fits your liver and why. One helpline serves every CION centre.