title: Combined Cisplatin-Based Chemoembolization and Radiation Therapy for Hepatocellular Carcinoma Invading the Main Portal Vein.
abstract: OBJECTIVE
  To evaluate the safety and survival outcome of chemoembolization plus radiation therapy (RT) in patients with hepatocellular carcinoma (HCC) with main portal vein (PV) tumor thrombosis.
  
  
  METHODS
  This retrospective study evaluated 151 patients with HCC and main PV involvement (101 with Child-Pugh class A liver function and 50 with Child-Pugh class B liver function) treated with combined cisplatin-based chemoembolization and RT. Medical records, imaging, and laboratory studies were reviewed, and complications, survival, and mortality rates were determined.
  
  
  RESULTS
  After chemoembolization, major complications occurred in 19.9% of patients, with the rate of major complications significantly higher in Child-Pugh class B cases than in Child-Pugh class A cases (32% vs 13.9%; P = .016). The 30-day mortality rate was 0.7%. One hundred forty-seven patients received adjuvant RT an average of 17.4 days after chemoembolization for main PV tumor thrombosis. Adjuvant RT could not be performed in four patients because of intolerance of the initial chemoembolization. There were no major complications after RT. The objective tumor response at 6 months was 25.2%, with a median survival of 12 months (14 mo in Child-Pugh class A cases and 8 mo in Child-Pugh class B cases). Patients with Child-Pugh class B liver function with extrahepatic metastases, no tumor response, and absence of second-line sorafenib treatment had poor survival.
  
  
  CONCLUSIONS
  Chemoembolization combined with RT improves survival, with a median survival of 12 months in patients with HCC with main PV involvement.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Sae Rom
authors.initials: SR
authors.lastname: Chung
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea. Electronic address: jhkimrad@amc.seoul.kr.
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Hyun-Ki
authors.initials: HK
authors.lastname: Yoon
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Gwon
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Heung Kyu
authors.initials: HK
authors.lastname: Ko
authors.affiliation: Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Yoon
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods / Q000401:mortality; D059248:Chemoradiotherapy / Q000379:methods / Q000401:mortality*; D002945:Cisplatin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy; D008297:Male; D009361:Neoplasm Invasiveness; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin