Patient description: A 35-year-old woman presents with history of acne and mild hirsutism. The primary evaluation revealed elevated testosterone levels. She recently noticed gradual enlargement of her hands and feet and recognized that her ring is getting small for her finger. There is some irregularity in her menstrual cycle as well as some nipple discharge. She also has positive history for snoring and headache. The physical examination revealed subtle facial features of acromegaly and prognathism. Visual fields are normal by confrontation. Hirsutism, soft tissue thickening and diaphoresis of the hands and feet are noted. Laboratory evaluation in the fasting state reveals IGF-1 of 968 ng/mL and random GH of 19.7 ng/mL. MRI reveals a macroadenoma with no invasion. She is on stable doses of octreotide LAR since her diagnosis was confirmed. She is married and has 2 children. She is using IUD as her contraceptive method.

Clinical trial eligibility criteria: eligible ages (years): 18.0-70.0,  Hepatocellular Carcinoma Eligible patients those with HCC based on the diagnostic of European Association for the Study of the Liver (EASL), either confirmed cyto-histologically or confirmed non-invasively (restricted to cirrhotic patients) by radiological (two coincident imaging techniques and focal lesion > 2 cm with arterial hypervascularization) or combined (one imaging technique associated with AFP, focal lesion > 2 cm with arterial hypervascularization, and AFP levels > 400 ng/ml) They have Child-Pugh grade A cirrhosis and are HBsAg-positive for more than 6 months These patients are not feasible for other conventional treatment modalities of treatment including surgery, transarterial embolization, ethanol injection, and radiofrequency ablation No systemic anti-cancer therapy with high priority is available All of the above 3 should be judged by the caring physician All intrahepatic disease must be encompassed within the radiation fields, except intrahepatic diseases outside the radiation field(s) have been controlled by other treatment modalities before radiotherapy Karnofsky Performance Scale ≧ 80 Age > 18 Adequate bone marrow function, defined as follows Absolute neutrophil count (ANC) > 1,000 cells/mm3 based upon CBC/differential obtained within 2 weeks prior to registration on study  Prior invasive malignancy, other than HCC, (except nonmelanomatous skin cancer) unless disease free for a minimum of 3 years (For example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible) Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields Tumor thrombosis in the main trunk of portal vein, hepatic vein, or inferior vena cava Child-Pugh grade B or C cirrhosis Extrahepatic metastasis Clinical ascites that requires diuretic treatment or paracentesis for symptom relief Serum alanine aminotransferase (ALT) level > 5X normal upper limits or total bilirubin level > 3.0 Active hepatitis (serum ALT level > 5X normal upper limits) or clinically significant liver failure Positivity of anti-HCV, pregnancy, nursing women, or women of childbearing potential, and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this is necessary because the treatment involved in this study may be significantly teratogenic