TECHNICAL CONSIDERATIONS FOR FRACTIONATED STEREOTAXIC RADIOTHERAPY OFHEPATOCELLULAR-CARCINOMA

Technical aspects of fractionated stereotactic radiotherapy for solita ry hepatocellular carcinoma have been investigated. Precise positionin g of the patient and substantial reduction of the liver movement due t o respiration were achieved by placing the patient ventrally on the tr eatment couch without a body cast, Repeated CT examinations were requi red for verification of tumor targeting, Though there were geometrical limitations on gantry rotation when the linac couch was rotated from its standard position, dose distributions obtained were found to be ex cellent. A patient with a small solitary lesion in the posterior segme nt of the liver received 52 Gy in 13 fractions over 29 days, He tolera ted the treatment well without experiencing any morbidities or deterio ration of liver functions. Three months later his cc-fetoprotein value returned to normal and CT examinations revealed tumor shrinkage as we ll as a reduction in the viability of the tumor cells. The results sug gest that it is possible to overcome technical difficulties associated with fractionated stereotactic radiotherapy of intraabdominal tumors.