Conformal radiation therapy for portal vein tumor thrombosis of hepatocellular carcinoma.
OBJECTIVE
The prognosis of patients with portal vein tumor thrombosis (PVTT) from hepatocellular carcinoma (HCC) is poor; without treatment, their survival is less than 3months. We retrospectively evaluated the treatment outcomes of conformal radiation therapy (CRT) in patients with HCC-PVTT.


METHODS
Thirty-eight HCC patients with PVTT in whom other treatment modalities were not indicated underwent CRT. The total dose was translated into a biologic effective dose (BED) of 23.4-59.5Gy(10) (median 50.7Gy(10)) as the alpha/beta ratio=10. Predictive factors including the age, performance status, Child-Pugh classification, PVTT size, and BED were evaluated for tumor response and survival.


RESULTS
Complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) were observed in 6 (15.8%), 11 (28.9%), 17 (44.7%), and 4 (10.5%) patients, respectively. The response rate (CR+PR) was 44.7%. The PVTT size (<30 vs. 30mm) and BED (<58 vs. 58Gy(10)) were significant factors for tumor response. The median survival and 1-year survival rate were 9.6months and 39.4%. The Child-Pugh classification (A vs. B) and BED were significant factors for survival.


CONCLUSIONS
CRT is effective not only for tumor response but also for survival in HCC-PVTT patients in whom other treatment modalities are not indicated.
Toya
Ryo
R
Department of Radiation Oncology, Kumamoto University Hospital, Honjo, Kumamoto, Japan. ryo108@m9.dion.ne.jp
Murakami
Ryuji
R
Baba
Yuji
Y
Nishimura
Ryuichi
R
Morishita
Shoji
S
Ikeda
Osamu
O
Kawanaka
Koichi
K
Beppu
Toru
T
Sugiyama
Shinichi
S
Sakamoto
Takashi
T
Yamashita
Yasuyuki
Y
Oya
Natsuo
N
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D020266:Radiotherapy, Conformal; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000532:radiotherapy*