Background: The prognogis of hepatocelluler carcinoma (HCC) with portal tumor thrombus(PTT) is very poor.

Methods: Seventy nine HCC cases with PTT from April 1999 to March 2005 were retrospectively surveyed and analyzed at Agast 2006.Twenty cases were treated with IVR alone and other 59 cases underwent RT combined with IVR.The backgrounds including the gender, the age, the degree of liver dysfunction, and the site of PTT showed no significant difference between two groups.This study included no case of Child C.The therapeutic methods of IVR are as follows; partial TAE in 39 cases, arterial reservoir placement in 16 cases, single arterial infusion in 51 cases.Gross tumor volume of radiation treatment included PTT and the whole tumor or partial tumor and planning target volume inclueded Gross tumor volume and 10mm margin. Three and five beams were concentrated planning target volume to reach 50Gr/25times/5weeks.

Results: Fifty nine cases passed away due to tumor growth (54), rupture of esophagel vauces (2) and Lung cancer (1).One year,two year and third year acturial survival rates of IVR alone and conformal RT with IVR were 40.3 vs 7.2 %,15.9 vs 0 % and 10.6 vs 0 % respectively. There was significant difference between two groups. The adverse effects of radiation treatment were gastrointentional damage in 2cases and liver failure in 2cases.

Conclusions: Confomal rediation treatment brought about to prolong the survival rate of HCC patients with PTT.