SBRT or TACE for Advanced HCC

Inclusion Criteria: * HCC (biopsy or radiological diagnostic (\>1 cm, enhancing in arterial phase and wash-out in later phases). * Number of lesions: not more than 3 lesions * Lesion size: up to 10 cm for a single lesion (and up to 10 cm cumulative diameter, if there is more than 1 lesion) * Child-Pugh A or B (\<7) on examination within 6 weeks prior to study entry * BCLC Stage A/B * Must be fit (eligible) for SBRT and TACE * Unsuitable/unwilling for resection or transplant or radiofrequency ablation (RFA) or if these options are not available * Distance between GTV (lesion) and luminal structures (including esophagus, stomach, duodenum, small or large bowel) is \>10 mm * All blood work obtained within 2 weeks prior to study entry with adequate organ function defined as follows: * Absolute neutrophil count (ANC) ≥ 1,500 cells/mm3 * Platelets ≥50,000 cells/mm3 * Hemoglobin ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve Hgb ≥ 8.0 g/dl is acceptable.) * Total bilirubin \< 2 mg/dL * Prothrombin time/INR \< 1.4 (unless on Coumadin/Warfarin) * Albumin ≥ 28 g/L * AST (and ALT) \< 5 times ULN * Serum creatinine ≤ ULN or creatinine clearance ≥ 60 mL/min * Left-ventricular ejection fraction \>50% (cardiac ejection fraction should be measured in case of history of cardio-vascular disease. * May have had previous surgery, ethanol injection and RFA to the liver Exclusion Criteria: * • Not suitable for clinical trial or follow-up * Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 2 years (Note that carcinoma in situ of the breast, oral cavity, or cervix are all permissible). No active cancer therapy. * Unsuitable for or refractory to transarterial hepatic chemo-embolization (TACE) * Non-enhancing HCC on CT or CT-angio or * Portal vein thrombosis/macroscopic venous invasion * Arterio-portal and arterio-venous fistulas observed on pre-study imaging (if it is found during the TACE, the fistula may be embolized before injection of the drug). * Evidence of metastatic disease including nodal or distant metastases. * Previous TACE or radiation to the liver (including SIRT) * Life-threatening condition (including untreated HIV and active hepatitis B/C) * Detectable HBeAg and HBV viral load \> 20,000 IU/mL or * HBeAg-negative chronic hepatitis B and HBV viral load \>2,000 IU/mL * If HBV-DNA copy is higher than 500 copies/ml, anti-viral therapy, such as Entecavir followed by observation for 2 weeks. * If anti-HCV antibody is positive (may be false positive) and increased HCV viral load indicating active disease. Active HCV should be treated sufficiently before inclusion in the study. Below 2 million copies per milliliter (mL) is related to chronic hepatitis C that does not need antiviral therapy. * Patients with active hepatitis B or C should be on treatment for at least 4 weeks before inclusion in the trial * On sorafenib or other antineoplastic drug therapy within 7 days before inclusion (not accepted until time of progression). * Pregnancy or women of childbearing potential require a negative pregnancy test within 28 days