title: Three-dimensional conformal radiotherapy of unresectable hepatocellular carcinoma patients for whom transcatheter arterial chemoembolization was ineffective or unsuitable.
abstract: OBJECTIVE
  To evaluate 3-dimensional conformal radiotherapy (3D-CRT) of unresectable hepatocellular carcinoma (HCC) patients for whom transcatheter arterial chemoembolization (TACE) was ineffective or unsuitable, and to determine whether tumor response and portal vein thrombosis (PVT) response to treatment were prognostic factors for overall survival.
  
  
  METHODS
  From July 2001 to June 2005, 70 unresectable HCC patients were treated with 3D-CRT; PVT was present in 41 patients. A daily radiation dose ranging from 2 to 3 Gy was administered using 6 or 15 MV x-rays to deliver a total dose between 44 and 54 Gy.
  
  
  RESULTS
  Of 70 patients, follow-up computed tomography showed that primary tumor responses were complete response (CR) in 4 (5.7%) patients, partial response (PR) in 34 (48.6%), no response (NR) in 28 (37.1%), and progressive disease (PD) in 4 (8.6%). Of 41 patients with PVT, PVT responses were CR in 4 (9.7%) patients, PR in 12 (29.3%), NR in 20 (48.8%), and PD in 5 (12.2%). The median survival times were 18.0 and 20.1 month in the primary tumor and the PVT responders (CR + PR), respectively, which were longer than the 6.8 and 7.2 months in the primary tumor and the PVT nonresponders (NR + PD), respectively.
  
  
  CONCLUSIONS
  3D-CRT was associated with a 54.3% objective response rate for primary tumors and a 39.0% objective response rate for PVT. Both primary tumor and PVT responses were found to be prognostic factors for overall survival. The present results suggest 3D-CRT is a practical treatment option in HCC patients for whom TACE is ineffective or unsuitable.
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Kim
authors.forename: Dae Yong
authors.initials: DY
authors.lastname: Kim
authors.forename: Joong-Won
authors.initials: JW
authors.lastname: Park
authors.forename: Young Il
authors.initials: YI
authors.lastname: Kim
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Hong Suk
authors.initials: HS
authors.lastname: Park
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Lee
authors.forename: Sang Jae
authors.initials: SJ
authors.lastname: Park
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Hong
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy*; D000075202:Contraindications; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020266:Radiotherapy, Conformal; D016019:Survival Analysis; D016896:Treatment Outcome; D020246:Venous Thrombosis