title: Endovascular brachytherapy combined with portal vein stenting and transarterial chemoembolization improves overall survival of hepatocellular carcinoma patients with main portal vein tumor thrombus.
abstract: Hepatocellular carcinoma (HCC) patients with main portal vein tumor thrombus have a median survival time of only about 4 months. We therefore compared the safety and efficacy of endovascular brachytherapy (EVBT) and sequential three-dimensional conformal radiotherapy (3-DCRT). From a cohort of 176 patients, we treated 123 with EVBT using iodine-125 seed strands (group A) and the remaining 53 with sequential 3-DCRT (group B). Overall survival, progression free survival and stent patency characteristics were compared between the two groups. Our analysis demonstrated a median survival of 11.7 ± 1.2 months in group A versus 9.5 ± 1.8 months in group B (p = 0.002). The median progression free survival was 5.3 ± 0.7 months in groupA versus 4.4 ± 0.4 months in group B (p = 0.010). The median stent patency period was 10.3 ± 1.1 months in group A versus 8.7 ± 0.7 months in group B (p = 0.003). Therefore, as compared to sequential 3-DCRT, EVBT combined with portal vein stenting and TACE improved overall survival of HCC patients with main portal vein tumor thrombus.
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Tian-Zhu
authors.initials: TZ
authors.lastname: Yu
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Qing-Xin
authors.initials: QX
authors.lastname: Liu
authors.affiliation: Department of Interventional Radiology, Yancheng Third People's Hospital, Southeast University, Yancheng, China.
authors.forename: Wen-Hui
authors.initials: WH
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Jing-Qin
authors.initials: JQ
authors.lastname: Ma
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Zi-Han
authors.initials: ZH
authors.lastname: Zhang
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Min-Jie
authors.initials: MJ
authors.lastname: Yang
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Shao-Chong
authors.initials: SC
authors.lastname: Zeng
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Luo
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Ling-Xiao
authors.initials: LX
authors.lastname: Liu
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Zhi-Ping
authors.initials: ZP
authors.lastname: Yan
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011169:Portal Vein / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications / Q000628:therapy*
keywords: endovascular brachytherapy; hepatocellular carcinoma; main portal vein; three-dimensional conformal radiotherapy; tumor thrombus