Onkológia 4/2010

Radiotherapy of hepatocellular carcinoma

Many years ago, surgery was the only satisfactory treatment modality for hepatocellular carcinoma (HCC), but it was limited only to selected cases. The main limiting factor for resection is liver function. Diagnostic methods have improved to an extent that small HCC less than 1 cm can be detected. More and more alternative approaches have been administered in the treatment for localized HCC, as radiofrequency ablation (RFA), percutaneous ethanol injection (PEI), radiotherapy and transarterial chemoembolization (TACE), radioisotops treatment. Radiotherapy underwent major technological improvements during the last decades, including new radiotherapy techniques: three dimensional conformal radiotherapy (3D CRT), intensity – modulated radiotherapy (IMRT), image guided radiotherapy (IGRT), stereotactic body radiosurgery. All these technological advances allow to treat liver tumours much more precisely, to deliver increased dose for smaller tumour size. Radiotherapy has gained increased consideration for treatment of HCC.

Keywords: radiotherapy, 3D conformal radiotherapy, stereotactic radiotherapy, radioisotops, protons.