**Author details**

**Figure 1.** Summary—HCC treatment decision chart in elderly recipients.

and none in US [65] (**Figure 1**).

rise in HCC incidence among elderlies [2].

**5. Conclusion**

48 Liver Cancer

These treatments are still experimental but results of trials until now are encouraging, in the

Hadrontherapy may be extremely interesting as a treatment also for elderlies, since it has little adverse effect and thanks to hypofractioning and noninvasivity; in the future, it may become a treatment of choice for difficult-to-treat HCC in elderly and for metastatic disease. It may ensure long-time tumor control and good QoL even in people advanced in age; the only issue of this treatment is its high cost-effectiveness ratio, even though cost-effectiveness trials for CPT are not still published a CPT apparatus costs around US\$ 200 million; only three carbon ion centers are available in Western Europe, seven in Asia (Japan and China),

The aim of this chapter is to give information and indications about the most recent operative and nonoperative existing techniques to treat HCC. Focus on older adults' case evaluation is of extreme importance; because lifespan enlargement will produce, in next decades, a sharp

next future hadrontherapy may be one of the pillaRs of advance HCC treatment.

Stefania Brozzetti<sup>1</sup> \*, Simone Bini1 , Leonardo Luca Chiarella1 , Katia Fazzi1 , Michele Di Martino2 and Mario Bezzi2

\*Address all correspondence to: stefania.brozzetti@uniroma1.it

1 Department of Surgery "Pietro Valdoni", University of Rome La Sapienza, Policlinico Umberto I, Rome, Italy

2 Department of Radiological Sciences, University of Rome La Sapienza, Policlinico Umberto I, Rome, Italy
