A Study of Standard Of Care Versus Radio Ablation in Early Stage HCC

This Phase II Prospective, parallel and open-label randomised control trial will investigate whether a radiotherapy technique (called SABR) can treat early stage liver cancer more effectively than current treatments which use heating probes directly inserted into the tumour or chemotherapy or radioactive particles injected into the blood supply of the tumour. Investigators hypothesize SABR will result in higher rates of freedom from local progression (FFLP) at 2 years compared to percutaneous thermal ablation ± TACE or transarterial therapies (TACE/TARE).The study will also look at other important outcomes such as progression free survival, overall survival, side effects, quality of life and people's experiences of their treatment.

Inclusion Criteria: 1\) Histological or radiological diagnosis of single, new HCC with largest diameter =8 cm (BCLC stage 0 or A). * a) If prior history of HCC, the prior HCC must have been: * Early stage, solitary HCC, =5 cm in size and, * Have arisen within a different liver segment to the current HCC and, * Treated with curative intent therapy \>2 years prior with no evidence of active disease at the site. * 2\) As per local multidisciplinary HCC meeting consensus patient is suitable for percutaneous thermal ablation and/or transarterial therapies and not suitable for or declined liver resection and not planned for liver transplantation. * 3\) Child-Pugh score =B7\* with no or diuretic-controlled ascites * 4\) ECOG performance status =2 * 5\) Platelets =50x109/L, Haemoglobin =80 g/L, Neutrophils =1.0x109/L, INR \