title: Application of helical tomotherapy for two cases of advanced hepatocellular carcinoma.
abstract: The role of radiotherapy in the treatment of hepatocellular carcinoma (HCC) has been limited to date, because the liver has a low tolerance to radiation. However, reconstructing tumors and surrounding organs via a three-dimensional conformal planning system can avoid excess radiotherapy exposure to the rest of the liver and adjacent organs. Recently, the concept of "adaptive radiotherapy," such as with helical tomotherapy, has been introduced for treating HCC. Helical tomotherapy obtains an image from the computed tomography component, which allows targeted regions to be visualized prior to, during, and immediately after each treatment and delivers intensity-modulated radiation therapy. We report two patients with advanced HCC who underwent tomotherapy treatment. One was a patient afflicted with advanced HCC and a portal vein tumor thrombus, which was treated with tomotherapy combined with transarterial chemolipiodolization. The other was a patient afflicted with multiple pulmonary metastases treated with tomotherapy followed by systemic chemotherapy.
authors.affiliation: Department of Internal Medicine, The Catholic University of Korea School of Medicine, Seoul, Korea.
authors.forename: Joon Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Chan Ran
authors.initials: CR
authors.lastname: You
authors.forename: Jeong Won
authors.initials: JW
authors.lastname: Jang
authors.forename: Si-Hyun
authors.initials: SH
authors.lastname: Bae
authors.forename: Jong Yong
authors.initials: JY
authors.lastname: Choi
authors.forename: Seung Kew
authors.initials: SK
authors.lastname: Yoon
authors.forename: Chul Seung
authors.initials: CS
authors.lastname: Kay
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D009361:Neoplasm Invasiveness; D011857:Radiographic Image Interpretation, Computer-Assisted; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome