Many years ago, surgery was the only satisfactory treatment modality for hepatocellular carcinoma (HCC), but it was limited only to selected cases. Diagnostic methods have improved to an extent that small HCC less than 1 cm can be detected. More and more alternative approaches have been administered in the treatment for localized HCC, as radiofrequency ablation (RFA), percutaneous ethanol injection (PEI), radiotherapy and trans-arterial chemo-embolization (TACE). Radiotherapy underwent major technological improvements during the last decades, including new radiotherapy techniques: three – dimensional conformal radiotherapy – 3D CRT, intensity – modulated radiotherapy – IMRT, image guided radiotherapy – IGRT, stereotactic body radio-surgery. All these technological advances allow to treat liver tumors much more precisely, to deliver increased dose for smaller tumor size. Radiotherapy has gained increased consideration for treatment of HCC. Moreover, a combination of different types of regional therapies may yield better outcomes in selected individuals.
Key worlds: radiotherapy, 3D conformal radiotherapy, stereotactic radiotherapy, radioisotops, protons