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Abstract
Hepatocellular carcinoma (HCC) is the most common type of primary hepatic carcinoma accounting for more than 80 % of malignant hepatic tumors It represents the fifth most common malignancy in men and the eighth in women worldwide, with approximately one million new cases and more than 250,000 deaths recorded annually. The condition is extremely common in South Asia and Tropical Africa; Conversely, HCC is relatively uncommon in the United States and Western Europe In Egypt, liver cancer is the future threat as the incidence is progressively increasing. There was a 20 fold increase in frequency of liver cancer in the National Cancer Institute in the period 1970 – 2000 This could be attributed to the high prevalence HBV and HCV. Also, the role of aflatoxin B1 cannot be neglected. According to the National Cancer Institute Registry hepatocellular carcinoma is the 4th most common cancer (after breast, bladder and lymphoma) accounting for approximately 8.1 % (12.9/100.000) of all cancer cases and accounting for 44% of all gastrointestinal tract cancer Although a wide range of therapeutic options is available, the efficacy of these methods and the prognosis remain very poor with a very few patients can be cured Surgery either by resection or liver transplantation is the only potentially curative therapy and it is the only treatment that offers long term survival..Other treatment modalities include RFA, local ethanol injection, arterial embolization, TACE, hormonal therapy, biological therapy, systemic chemotherapy and targeted therapy Conventional Radiation therapy has a limited role in treating hepato cellular carcinoma patients due to poor radiation tolerance of the liver. The new technology of the three-dimensional conformal treatment planning and therapy) allows highly précised dose delivery to a specific target volume with better sparing of normal tissues.