Korean J Intern Med.  2011 Jun;26(2):201-206. 10.3904/kjim.2011.26.2.201.

Application of Helical Tomotherapy for Two Cases of Advanced Hepatocellular Carcinoma

• Kim JS
• You CR
• Jang JW
• Bae SH
• Choi JY
• Yoon SK
• Kay CS

• KMID: 1776593
• DOI: http://doi.org/10.3904/kjim.2011.26.2.201

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.

Keyword

Carcinoma, hepatocellular; Venous thrombosis; Metastasis; Radiotherapy

MeSH Terms

Adult
Carcinoma, Hepatocellular/radiography/*radiotherapy/secondary
Chemotherapy, Adjuvant
Dose Fractionation
Female
Humans
Imaging, Three-Dimensional
Liver Neoplasms/pathology/radiography/*radiotherapy
Male
Neoplasm Invasiveness
Radiographic Image Interpretation, Computer-Assisted
*Radiotherapy Planning, Computer-Assisted
*Radiotherapy, Conformal
*Tomography, Spiral Computed
Treatment Outcome