Efficacy of radiotherapy for PV and IVC tumor thrombosis in unresectable HCC.
OBJECTIVE
The purpose of this study is to evaluate the effect of radiation therapy (RT) for tumor thrombosis (TT) in the major portal vein (PV) or inferior vena cava (IVC) from unresectable hepatocellular carcinoma.


METHODS
Fifteen HCC patients with main PVTT (n = 10) and IVCTT (n 5) were treated with three-dimensional conformal RT between 2001 and 2004. The mean dose was 38.5 Gy (range 28 to 54Gy). The concurrent therapies to intrahepatic tumor included transcatheter arterial chemoembolization (TACE) in 7, TACE + hepatic arterial infusion in 2 and systemic chemotherapy in 1 patient. The therapeutic effect was assessed by tumor regression for TT.


RESULTS
An objective response was observed in 3 of 15 patients (20%). There were no patients with progressive disease. The median survival time was 10 months. In 12 cases with stable disease, time to progression (TTP) estimated above 6 months were 42% (5/12 cases). In univariate analysis, therapeutic effect and TTP were affected to survival time. All patients did not have severe deterioration of liver function.


CONCLUSIONS
In the current study, we concluded that RT was superior treatment in terms of local control capability and was useful to continue further treatment because RT did not make liver function worse.
Sugiyama
Shinichi
S
Department of Gastroenterological Surgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Japan. sammy12rugby@msn.com
Beppu
Toru
T
Ishiko
Takatoshi
T
Takahashi
Masashi
M
Masuda
Toshiro
T
Hirata
Takahumi
T
Imai
Katsunori
K
Hayashi
Hiromitsu
H
Takamori
Hiroshi
H
Kanemitsu
Keiichiro
K
Hirota
Masahiko
M
Murakami
Ryuji
R
Baba
Yuji
Y
Oya
Natsuo
N
Yamashita
Yasuyuki
Y
Baba
Hideo
H
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000532:radiotherapy*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology / Q000528:radiation effects*; D011878:Radiotherapy / Q000379:methods*; D013927:Thrombosis; D013997:Time Factors; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000473:pathology / Q000528:radiation effects*