Palliative Radiotherapy

Abstract

Palliative radiotherapy (RT) is a relative term, which refers to the use of RT in situations when it is impossible to completely eliminate all visible lesions. It contrasts with radical RT, in which the goal is complete elimination of visible tumors. One or both of the following conditions are regarded as palliative RT: (1) the radiation dose fails to achieve radical goals unless combined with other radical treatments, such as surgical resection; and (2) visible lesions exist beyond the radiation fields. Since radical goals cannot be achieved, palliative RT aims to relieve cancer symptoms and slightly prolong survival. A considerable proportion of patients with hepatocellular carcinoma (HCC) have intrahepatic lesions that may be converted to sequential surgical resection after the combination of RT and transarterial chemoembolization (TACE). We classify this type of RT as consolidation RT, not palliative RT. This chapter discusses the use of RT for portal vein (PV)/inferior vena cava (IVC) tumor thrombi, as well as extrahepatic metastatic lesions, including lymph node (LN), bone, pulmonary, and adrenal metastases.