title: Three-dimensional conformal radiotherapy for hepatocellular carcinoma with inferior vena cava invasion.
abstract: 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 treatment for hepatocellular carcinoma with inferior vena cava invasion by three-dimensional conformal 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 tomography 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.
authors.affiliation: Department of Radiology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. igaki-tky@umin.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Igaki
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Kenshiro
authors.initials: K
authors.lastname: Shiraishi
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Atsuro
authors.initials: A
authors.lastname: Terahara
authors.forename: Hideomi
authors.initials: H
authors.lastname: Yamashita
authors.forename: Nakashi
authors.initials: N
authors.lastname: Sasano
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
authors.forename: Kuni
authors.initials: K
authors.lastname: Ohtomo
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D019043:Vascular Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D014682:Vena Cava, Inferior / Q000473:pathology*