title: Efficacy of three-dimensional conformal radiotherapy combined with transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus.
abstract: OBJECTIVE
  The current study aimed to evaluate the efficacy and outcomes of three-dimensional conformal radiotherapy (3DCRT) combined with transarterial chemoembolization (TACE) for treating patients with hepatocellular carcinoma involving portal vein tumor thrombus.
  
  
  METHODS
  Between January 2000 and December 2013, a total of 182 hepatocellular carcinoma patients with portal vein tumor thrombus were retrospectively analyzed: 68 patients were treated by 3DCRT alone (group A), 74 by TACE alone (group B), and 40 by a combination of 3DCRT + TACE (group C). The overall survival (OS) of the three groups was compared using the Kaplan-Meier method. The independent predictors of survival were identified using multivariate analysis.
  
  
  RESULTS
  The total effective rate (complete response + partial response) among all patients was 44% (80/182). The objective response rate (complete response + partial response) was higher in group C than in group A or B, but the differences were not significant. OS rates at 1, 2, and 3 years were significantly higher in group C than in group A or B (P<0.05), while OS rates were similar between groups A and B. Multivariate analysis identified serum levels of alpha-fetoprotein <400 ng/mL and the use of 3DCRT + TACE as independent predictors of better OS.
  
  
  CONCLUSIONS
  These results suggest that combining 3DCRT with TACE may provide better OS than either technique alone in hepatocellular carcinoma patients with portal vein tumor thrombus.
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning; Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Ministry of Education, Shanghai.
authors.forename: Fei-Xiang
authors.initials: FX
authors.lastname: Wu
authors.affiliation: Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning.
authors.forename: Hui-Rong
authors.initials: HR
authors.lastname: Lu
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning.
authors.forename: Shao-Liang
authors.initials: SL
authors.lastname: Zhu
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning.
authors.forename: Zi-Hui
authors.initials: ZH
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning.
authors.forename: Ling
authors.initials: L
authors.lastname: Zou
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning.
authors.forename: Tao
authors.initials: T
authors.lastname: Bai
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning.
authors.forename: Tian-Bo
authors.initials: TB
authors.lastname: Yang
authors.affiliation: Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning; Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Shi-Xiong
authors.initials: SX
authors.lastname: Liang
keywords: hepatocellular carcinoma; overall survival; portal vein tumor thrombus; three-dimensional conformal radiotherapy; transarterial chemoembolization