Conformal irradiation for hepatobiliary malignancies

The term 'conformal irradiation' is usually used to describe the delivery o f sophisticated high dose external beam irradiation (EBRT) with the aid of 3-D treatment planning and the option of both coplanar and non-coplanar bea ms. Data will be presented from the University of Michigan which suggest th at conformal high dose EBRT (48-72.6 Gy) can be used for intrahepatic cance rs, both hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (LHCC), to potentially increase local control and survival over what would be expected with lower dose EBRT. For purpose of this discussion, the term . conformal irradiation will be expanded to include other techniques which conform the high dose irradiation boost volume in close proximity to unrese cted tumor or positive margins of resection. Data will be presented from se ries which utilize transcatheter iridium and intraoperative electron irradi ation (IOERT) supplements to EBRT +/- concomitant chemotherapy. Each method intensifies treatment in an attempt to improve local control and survival.