title: Trans-arterial chemoembolization and external beam radiation therapy for treatment of hepatocellular carcinoma with a tumor thrombus in the inferior vena cava and right atrium.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) with a tumor thrombus in the inferior vena cava (IVC) and right atrium (RA) rarely occurs and is usually associated with extremely poor prognosis, we carried out this study to evaluate the efficacy and safety of a combination of trans-arterial chemoembolization (TACE) and external beam radiation therapy (EBRT) in the treatment of HCC with a tumor thrombus in the IVC and RA.
  
  
  METHODS
  From September 2005 to September 2008, 11 cases of HCC with a tumor thrombus in the IVC and RA were treated with a combination of TACE and EBRT. Clinical adverse events, laboratory toxicity, and survival were retrospectively studied.
  
  
  RESULTS
  Thirty-one interventional procedures were conducted and EBRT was performed 11 times. All treatments were successful and without significant complications. No severe adverse effects were observed. The median survival time of the 11 cases was 21.0 months. One patient was monitored for 97 months and no recurrence was observed.
  
  
  CONCLUSIONS
  The combination of TACE and EBRT can be safely performed and may improve the prognosis of the HCC cases with a tumor thrombus in the IVC and RA.
authors.affiliation: Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. duanfeng@vip.sina.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Duan
authors.affiliation: Department of Radiotherapy, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. yuwei@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. wang_yan_301@hotmail.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. fengyongliu@yahoo.com.
authors.forename: Feng-yong
authors.initials: FY
authors.lastname: Liu
authors.affiliation: Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. huolieniao2700@sina.com.
authors.forename: Peng
authors.initials: P
authors.lastname: Song
authors.affiliation: Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. wangzj301hospital@163.com.
authors.forename: Zhi-jun
authors.initials: ZJ
authors.lastname: Wang
authors.affiliation: Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. mczlks@sina.com.
authors.forename: Jie-yu
authors.initials: JY
authors.lastname: Yan
authors.affiliation: Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. yuankai80601@126.com.
authors.forename: Kai
authors.initials: K
authors.lastname: Yuan
authors.affiliation: Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. wangmq@vip.sina.com.
authors.forename: Mao-qiang
authors.initials: MQ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D006325:Heart Atria; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011829:Radiation Dosage; D015641:Radiography, Interventional; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal; D012189:Retrospective Studies; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000473:pathology*