With the advent of three-dimensional conformal radiotherapy
and more understanding of partial liver tolerance,
radiotherapy has been increasingly incorporated into the
treatment of hepatocellular carcinoma (HCC). Reported
results of novel techniques to deliver higher dose radiation,
such as stereotactic body radiotherapy and proton beam
therapy, are not only feasible but also promising [1, 2]. In
contrast, HCC has rarely been an indication of intensitymodulated
radiation therapy (IMRT) due to the organ
motion during respiration, although several dosimetric
studies have been reported on the benefit of IMRT in HCC
[3, 4]. However, with image-guidance technology, liver
tumours can be treated with IMRT safely and efficiently.
Recently, a study on IMRT using Hi-Art tomotherapy
(TomoTherapy Inc., Madison, WI) for patients with
unresectable HCC reported lower toxicity with promising
local control [5]