title: Multimodality treatment involving radiotherapy for advanced liver-confined hepatocellular carcinoma.
abstract: BACKGROUND
  Advanced-stage hepatocellular carcinoma (HCC) has an extremely poor prognosis although sorafenib, which is the treatment of choice, has provided survival benefits. Among advanced diseases, liver-confined HCC, which invades the vasculature without extrahepatic metastasis, requires novel therapeutic management beyond using sorafenib alone. Currently, the Korean Liver Cancer Study Group and National Comprehensive Cancer Network guidelines recommend combined radiotherapy (RT) and chemotherapy for some selected cases. For advanced liver-confined HCC, focal liver irradiation, RT technological development, and optimal selection of RT-suitable patients enable clinicians to use RT-involving multimodality treatments based on oncologic principles, such as concurrent chemoradiotherapy, which represent effective multimodality treatments for several types of malignancy.
  
  
  CONCLUSIONS
  In this review, we discuss the need to develop novel therapeutic approaches for liver-confined HCC and clinical applications of RT-involving multimodality treatments for advanced liver-confined HCC.
  
  
  CONCLUSIONS
  RT-involving multimodality treatments can enhance the overall therapeutic successes for advanced liver-confined HCC and also provide potential cures to some patients via conversion to a resectable condition.
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hong In
authors.initials: HI
authors.lastname: Yoon
authors.forename: Jinsil
authors.initials: J
authors.lastname: Seong
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy / Q000379:methods; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D009367:Neoplasm Staging; D009536:Niacinamide / Q000031:analogs & derivatives / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D018714:Radiotherapy, Adjuvant; D056910:Republic of Korea; D000077157:Sorafenib; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: C097353:AFP protein, human; D000970:Antineoplastic Agents; D015415:Biomarkers; D014408:Biomarkers, Tumor; D010671:Phenylurea Compounds; D011498:Protein Precursors; D000509:alpha-Fetoproteins; D009536:Niacinamide; C008208:acarboxyprothrombin; D011516:Prothrombin; D000077157:Sorafenib