title: Tolerability and efficacy of gamma knife radiosurgery on hepatocellular carcinoma with portal vein tumor thrombosis.
abstract: This is a retrospective study on the safety and efficacy of gamma knife radiosurgery (GKR) in treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Patients with confirmed HCC and PVTT were allocated into two groups based on the treatments they received (palliative or GKR). A total of 138 patients were included (74 in the palliative group, 64 in GKR group). No significant differences in baseline characteristics existed between the two groups. Treatment-related adverse events (AEs) were recorded and compared between groups. The majority of AEs were mild to moderate and subsided naturally or after medication. There was no AE-induced death. The influences of baseline characteristics and treatment options on patients' OS were analyzed. The median OS of patients in the palliative and GKR group were 3.0 months (95% CI: 2.719-3.281) and 6.1 months (95% CI: 4.706-7.494) respectively (p = 0.003). Multivariate analysis revealed that GKR treatment, performance status 0-1, Child A, smaller tumor diameter and monolobar distribution were significant favorable prognosticators. Subgroup analyses showed OS benefit of GKR regardless of PVTT location (main or branch of PVTT). In conclusion, GKR is well tolerated in selected HCC-PVTT patients and can confer OS benefit, which needs validation in future prospective studies.
authors.affiliation: Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xiao-Jie
authors.initials: XJ
authors.lastname: Lu
authors.affiliation: Outpatient Department, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Dong
authors.affiliation: Department of Rehabilitation, The Affiliated Huai'an Hospital of Xuzhou Medical College and The Second People's Hospital of Huai'an, Huai'an, China.
authors.forename: Li-Juan
authors.initials: LJ
authors.lastname: Ji
authors.affiliation: Department of Gamma Knife, The 411st Hospital of Chinese People's Liberation Army, Shanghai, China.
authors.forename: Li-Xin
authors.initials: LX
authors.lastname: Xiao
authors.affiliation: Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China.
authors.forename: Chang-Quan
authors.initials: CQ
authors.lastname: Ling
authors.affiliation: Department of Oncology and Hematology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011169:Portal Vein / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D016634:Radiosurgery; D012189:Retrospective Studies; D015996:Survival Rate; D020246:Venous Thrombosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
keywords: adverse events; gamma knife; hepatocellular carcinoma; overall survival; portal vein tumor thrombosis