Three-dimensional Conformal Radiotherapy for Hepatocellular Carcinoma with Inferior Vena Cava Invasion

Background: Hepatocellular carcinoma with inferior vena cava invasion is a rare but fatal condition of disease progression. The aim of this study was to analyze the results of treat-ment for hepatocellular carcinoma with inferior vena cava invasion by three-dimensional con-formal radiation therapy. Methods: From 1990 to 2006, 18 histopathologically confirmed hepatocellular carcinoma patients with inferior vena cava invasion who were unsuitable for surgery were treated by three-dimensional conformal radiation therapy at our hospital with two to four static or dynamic conformal arc fields. Results: A median total tumor dose of 50 Gy (range 30–60 Gy) was delivered. The progression-free rate was 91.6 % among the patients in whom follow-up computed tomogra-phy was obtained. Actuarial survival at 1 year was 33.3%, and the median survival period was 5.6 months. Conclusions: Three-dimensional conformal radiation therapy might offer a chance of long survival for a part of the hepatocellular carcinoma patients with inferior vena cava invasion, since a third of such patients survived more than a year. Additional treatments should be considered to prevent distant metastases and hepatic functional deterioration after three-dimensional conformal radiation therapy. Key words: hepatocellular carcinoma – inferior vena cava – three-dimensional conformal radiation therapy – hepatic functional reserve – liver cirrhosi