To the Editor,
We read the article Surgical resection versus conformal radiotherapy combined with TACE for resectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT): a comparative study by Tang et al.  with great interest. This article will be a useful guide for physicians in the future. In that paper, the authors suggested three-dimensional conformal radiotherapy (3D-CRT) is more useful than surgery in patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). This study showed that the overall survival of patients was better with 3D-CRT than with surgery.
The authors compared only two alternative therapies for HCC: surgery and 3D-CRT. In addition to these therapies, transarterial radioembolization with yttrium-90 (Y-90) microspheres has also been used for these cases, which avoids many of the limitations of external techniques . In our institution, we also perform Y-90 radioembolization in cases of HCC with PVTT.