Hepatocellular carcinoma (HCC) is a common cause of cancer mortality and morbidity worldwide. Radiation therapy is an underutilized therapy in HCC. A case of a 47-year-old man with locally advanced, chemorefractory HCC with malignant extension into the inferior vena cava and the right atrium, causing cardiac outflow obstruction, which was successfully treated with external beam radiation therapy, is presented. Low-dose radiation therapy is an effective palliative therapy for HCC that is widely available in most developing countries, where HCC is endemic.
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