Komatsu S, et al. - Authors here performed a comparison of the outcomes of particle radiotherapy and liver resection in patients with hepatocellular carcinoma with inferior vena cava tumor thrombus. In hepatocellular carcinoma patients with stage IIIB inferior vena cava tumor thrombus, particle radiotherapy was potentially preferable and at least equal in efficiency to liver resection in those with stage IV disease, while causing significantly fewer complications. Compared to liver resection, particle radiotherapy was associated with the relatively high survival and low invasiveness. Thus, for hepatocellular carcinoma with inferior vena cava tumor thrombus, this approach could represent a novel treatment modality.