title: Radiation therapy for portal venous invasion by hepatocellular carcinoma.
abstract: OBJECTIVE
  To clarify the efficacy and safety of three-dimensional conformal radiotherapy (3-D CRT) for this disease and to specify patient subgroups suitable for this treatment.
  
  
  METHODS
  Fifty-two patients with HCC received PVI-targeted radiation therapy from January 1995 through December 2003. Portal venous invasion (PVI) was found in the second or lower order branches of the portal vein in 6 patients, in the first branch in 24 patients and in the main trunk in 22 patients. Child classifications of liver function before radiation therapy were A, B, and C for 19, 24 and 2 patients, respectively. All patients received three-dimensional conformal radiotherapy with a total dose ranging from 39 to 60 Gy (57.0 Gy in average).
  
  
  RESULTS
  Overall survival rates at 1, 2, 3, 4, and 5 years were 45.1%, 25.3%, 15.2%, 10.1%, and 5.1%, respectively. Univariate analysis revealed that Child status, the number of tumor foci, tumor type, transcatheter arterial embolization (TAE) after radiation therapy were statistically significant prognostic factors. Multivariate analysis showed that the number of tumor foci and TAE after radiation therapy were statistically significant.
  
  
  CONCLUSIONS
  The results of this study strongly suggest the efficacy of 3-D CRT as treatment for PVI in HCC. 3-D CRT is recommended in combination with post-radiation TAE for PVI of HCC with 5 tumor foci or less in the liver and with Child A liver function.
authors.affiliation: Department of Radiology, Faculty of Medicine, University of Tokyo 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan. nakagawa-rad@umin.ac.jp
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Hideomi
authors.initials: H
authors.lastname: Yamashita
authors.forename: Kenshiro
authors.initials: K
authors.lastname: Shiraishi
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakamura
authors.forename: Masao
authors.initials: M
authors.lastname: Tago
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Igaki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hosoi
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
authors.forename: Kuni
authors.initials: K
authors.lastname: Ohtomo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011169:Portal Vein / Q000473:pathology; D011172:Portography; D020266:Radiotherapy, Conformal; D015996:Survival Rate