10-15% of patients diagnosed with hepatocellular cancer present with tumor invading the portal vein. In about half of these patients, the cancer is limited to segmental branches. (circled X) These patients can be treated with 3D conformal radiation or gamma knife to the cancer within the portal vein to stop its growth in combination with sorafenib. This approach also may allow the possibility of further treatment to destroy the cancer in the liver via hepatic artery chemo-embolization.