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Radiotherapy
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Radiotherapy uses radiation to kill cancer cells. Radiotherapy can be used in case of one large tumor with a few satellites (smaller tumors around it) and a sufficient amount of healthy liver to be spared. Possible techniques are the following:
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External radiotherapy by three-dimensional conformal radiotherapy (3D-CRT):
Radiations are produced by a device outside of the body and are then directed towards the tumor. It is called 3D-conformational because, unlike with classic external radiotherapy technique, a computer calculates the exact direction and shape of the radiation beams. This helps to direct them very precisely to the tumor and to leave as many normal liver cells as possible unharmed. This strategy can be applied in patients with no cirrhosis or cirrhosis grade A according to Child-Pugh and invasion of the inferior vena cava, or for patients with blood clots in the main branch of the portal vein (portal vein thrombosis).
Side effects of external radiation therapy include sunburn-like skin problems where the radiation enters the body, nausea, vomiting, and, most often, fatigue.
Stereotactic body radiation therapy (SBRT):
Instead of giving small doses of radiation each day for several weeks, SBRT uses much focused beams of high-dose radiation given on one or a few days. Beams are aimed at the tumor from many different angles. To target the radiation precisely, the person is put in a specially designed body frame for each treatment.
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