title: The effectiveness of particle radiotherapy for hepatocellular carcinoma associated with inferior vena cava tumor thrombus.
abstract: BACKGROUND
  The prognosis of patients who have hepatocellular carcinoma (HCC) associated with inferior vena cava tumor thrombus (IVCTT) is very poor, and effective treatment modalities are extremely limited. The objective of this study was to determine the therapeutic efficacy of particle radiotherapy for HCC with IVCTT.
  
  
  METHODS
  Between June 2001 and January 2009, 16 evaluable patients who had HCC with IVCTT were treated with particle radiotherapy. They were divided into 2 groups: 6 were treated with curative intent; 10 with palliative intent. The local tumor control rates, overall survival rates, and toxicities were evaluated.
  
  
  RESULTS
  All tumors treated with particle radiotherapy remained controlled without local recurrence at the last follow-up. The overall survival rates for the 16 patients at 1 and 3 years were 61.1 and 36.7%, respectively. We observed a significant difference in the survival rates according to treatment policy. The median survival time was 25.4 months for patients treated with curative intent and 7.7 months for those treated with palliative intent. The one-year survival rates were 100.0 and 33.3%, respectively. No Grade 3 or higher treatment-related toxicities were observed.
  
  
  CONCLUSIONS
  Particle radiotherapy is thought to be potentially effective and safe for HCC with IVCTT. Considering the current lack of effective and less-invasive local therapy for HCC with IVCTT, particle radiotherapy may therefore be an attractive new therapeutic approach for this type of HCC.
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Takumi
authors.initials: T
authors.lastname: Fukumoto
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Demizu
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyawaki
authors.forename: Kazuki
authors.initials: K
authors.lastname: Terashima
authors.forename: Yasue
authors.initials: Y
authors.lastname: Niwa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mima
authors.forename: Osamu
authors.initials: O
authors.lastname: Fujii
authors.forename: Ryohei
authors.initials: R
authors.lastname: Sasaki
authors.forename: Isamu
authors.initials: I
authors.lastname: Yamada
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hori
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hishikawa
authors.forename: Mitsuyuki
authors.initials: M
authors.lastname: Abe
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
authors.forename: Masao
authors.initials: M
authors.lastname: Murakami
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000528:radiation effects*; D011882:Radiotherapy, High-Energy; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior