title: Three-dimensional conformal radiotherapy for hepatocellular carcinoma in patients unfit for resection, ablation, or chemotherapy: a retrospective study.
abstract: OBJECTIVE
  The purpose is to evaluate the feasibility, efficacy, and the toxicity of three-dimensional conformal radiotherapy (3DCRT) in patients with advanced hepatocelluar carcinoma (HCC) and inferior vena cava tumor thrombosis (IVCTT).
  
  
  METHODS
  Between 2007 and 2012, in a retrospective way, 9 patients (median age 69 years) with advanced HCC and IVCTT unfit for surgery, radiofrequency ablation, embolization, or chemotherapy were treated with three-dimensional conformal radiotherapy (3DCRT). The radiotherapy volume included both primary tumor and IVTT. The radiotherapy schedule was 50-52 Gy in 2 Gy fractions. Overall survival (OS), response to radiotherapy, visual analogue scale (VAS), and toxicity were assessed.
  
  
  RESULTS
  All patients demonstrated a response rate up to 60%. During radiotherapy, 3 patients experienced grade 1 nausea/vomit toxicity. All patients demonstrated an elevation of the liver enzymes (3 patients with grade 1 and 6 patients with grade 2). The mean VAS-score was decreased from 6.11 to 3.11, while the median overall survival was 24 months.
  
  
  CONCLUSIONS
  3DCRT achieves a very high local control rate and is suitable for patients with HCC and IVTT, while the documented radiation induced toxicity is moderate. It can be recommended for palliation in patients unable to undergo curative therapies.
authors.affiliation: Radiotherapy Unit, 2nd Department of Radiology, ATTIKON University Hospital, Medical School, Athens, Rimini 1, 12462 Xaidari, Greece.
authors.forename: Vassilis
authors.initials: V
authors.lastname: Kouloulias
authors.affiliation: Radiotherapy Unit, 2nd Department of Radiology, ATTIKON University Hospital, Medical School, Athens, Rimini 1, 12462 Xaidari, Greece.
authors.forename: Eftychia
authors.initials: E
authors.lastname: Mosa
authors.affiliation: Radiotherapy Unit, 2nd Department of Radiology, ATTIKON University Hospital, Medical School, Athens, Rimini 1, 12462 Xaidari, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Georgakopoulos
authors.affiliation: Radiotherapy Unit, 2nd Department of Radiology, ATTIKON University Hospital, Medical School, Athens, Rimini 1, 12462 Xaidari, Greece.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Platoni
authors.affiliation: Radiotherapy Unit, 2nd Department of Radiology, ATTIKON University Hospital, Medical School, Athens, Rimini 1, 12462 Xaidari, Greece.
authors.forename: Ilias
authors.initials: I
authors.lastname: Brountzos
authors.affiliation: Radiotherapy Unit, 1st Department of Radiology, Aretaieion University Hospital, Medical School, Athens, Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Zygogianni
authors.affiliation: Radiotherapy Unit, 1st Department of Radiology, Aretaieion University Hospital, Medical School, Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Antypas
authors.affiliation: Medical Oncology Unit, Ygeia Hospital, Athens, Greece.
authors.forename: Paraskevas
authors.initials: P
authors.lastname: Kosmidis
authors.affiliation: Radiotherapy Unit, 1st Department of Radiology, Aretaieion University Hospital, Medical School, Athens, Greece.
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Mystakidou
authors.affiliation: Radiotherapy Unit, 2nd Department of Radiology, ATTIKON University Hospital, Medical School, Athens, Rimini 1, 12462 Xaidari, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Tolia
authors.affiliation: Radiotherapy Unit, 2nd Department of Radiology, ATTIKON University Hospital, Medical School, Athens, Rimini 1, 12462 Xaidari, Greece.
authors.forename: Ivelina
authors.initials: I
authors.lastname: Beli
authors.affiliation: Radiotherapy Unit, 1st Department of Radiology, Aretaieion University Hospital, Medical School, Athens, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Gouliamos
authors.affiliation: Radiotherapy Unit, 1st Department of Radiology, Aretaieion University Hospital, Medical School, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kouvaris
authors.affiliation: Radiotherapy Unit, 2nd Department of Radiology, ATTIKON University Hospital, Medical School, Athens, Rimini 1, 12462 Xaidari, Greece.
authors.forename: Nikoalos
authors.initials: N
authors.lastname: Kelekis
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome