الفهرس 
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Abstract
There are two blood vessels that provide oxygen and nutrients to the liver: the portal vein and the hepatic artery. Patients with HCC may undergo TACE if both the hepatic artery and portal vein are functional. This ensures that the hepatocytes continue to get oxygen and nutrients even if the hepatic artery is blocked. However, TACE is ineffective in patients with thrombosis of the portal system because following the procedure, neither the hepatic artery nor the portal vein carry blood to the hepatocytes. Because of the potential for recanalization of the portal vein after radiation to the PVT in HCC, further local treatments such as TACE may be possible. Consequently, combining RT with TACE may increase the patient’s chance of survival.
Therefore, in correctly chosen patients, hypo-fractionated radiation may be an acceptable local therapeutic option for PVTT without generating significant toxicity and with propability of survival benefit. A multivariate study of predictive markers for survival found that shifts in Child-Pugh score, changes in performance status, and RT’s effectiveness were all statistically significant predictors of patient survival.
Careful patient selection taking into account HFL size and location, PVTT extent, liver functional state (CHILD score), and performance level might improve results.