Three-dimensional conformal radiotherapy for portal vein tumor thrombosis alone in advanced hepatocellular carcinoma.
10.3857/roj.2014.32.3.170
- Author:
Ju Hye LEE
1
;
Dong Hyun KIM
;
Yong Kan KI
;
Ji Ho NAM
;
Jeong HEO
;
Hyun Young WOO
;
Dong Won KIM
;
Won Taek KIM
Author Information
1. Department of Radiation Oncology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. rokwt@hanmail.net
- Publication Type:Original Article
- Keywords:
Radiotherapy;
Hepatocellular carcinoma;
Portal vein
- MeSH:
Carcinoma, Hepatocellular*;
Humans;
Palliative Care;
Portal Vein*;
Radiotherapy;
Radiotherapy, Conformal*;
Retrospective Studies;
Survival Rate;
Thrombosis*
- From:Radiation Oncology Journal
2014;32(3):170-178
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We sought to evaluate the clinical outcomes of 3-dimensional conformal radiation therapy (3D-CRT) for portal vein tumor thrombosis (PVTT) alone in patients with advanced hepatocellular carcinoma. MATERIALS AND METHODS: We retrospectively analyzed data on 46 patients who received 3D-CRT for PVTT alone between June 2002 and December 2011. Response was evaluated following the Response Evaluation Criteria in Solid Tumors. Prognostic factors and 1-year survival rates were compared between responders and non-responders. RESULTS: Thirty-seven patients (80.4%) had category B Child-Pugh scores. The Eastern Cooperative Oncology Group performance status score was 2 in 20 patients. Thirty patients (65.2%) had main or bilateral PVTT. The median irradiation dose was 50 Gy (range, 35 to 60 Gy) and the daily median dose was 2 Gy (range, 2.0 to 2.5 Gy). PVTT response was classified as complete response in 3 patients (6.5%), partial response in 12 (26.1%), stable disease in 19 (41.3%), and progressive disease in 12 (26.1%). There were 2 cases of grade 3 toxicities during or 3 months after radiotherapy. Twelve patients in the responder group (15 patients) received at least 50 Gy irradiation, but about 84% of patients in the non-responder group received less than 50 Gy. The 1-year survival rate was 66.8% in responders and 27.4% in non-responders constituting a statistically significant difference (p = 0.008). CONCLUSION: Conformal radiotherapy for PVTT alone could be chosen as a palliative treatment modality in patients with unfavorable conditions (liver, patient, or tumor factors). However, more than 50 Gy of radiation may be required.
