The incidence of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is very high,and the prognosis is often unsatisfactory.Currently,some therapy such as radiotherapy or radiation combined with interventional therapy are effective and worth attention.Radiation therapy was divided into external beam radiation therapy and internal beam radiation therapy according to different administration pathway.This article summarized the current situation and prospect of radiotherapy.

Hepatocellular carcinoma (HCC) is prone to invading portal vein system known as portal vein tumor thrombus (PVTT).PVTT is one of the main reasons for poor prognosis of HCC because of its rapid progress and lack of effective treatments.In recent years,with the development of new therapeutic concepts and methods,the curative effect of PvTr has been improved.But there are still many difficulties of treatment of PVTT:how to definite the indications of various treatment of PVTT,how to innovate treatment methods,how to carry out the multidisciplinary treatment and how to conduct high-quality evidence-based clinical research.The strategies need to be built for these bottlenecks.Chinese Expert Consensus on Multidisciplinary Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus (2016 edition) also provided a powerful reference experience for clinical treatment and research.Researchers should develop new treatment methods,popularize the idea of multidisciplinary treatment and conduct high-quality evidence-based clinical research in the future to improve the curative effect of PVTT patients.

BACKGROUND: Chemotherapy is a common treatment for advanced hepatocellular carcinoma, but the effect is not satisfactory. The study aimed to retrospectively evaluate the effects of adding all-trans-retinoic acid (ATRA) to infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) for advanced hepatocellular carcinoma (HCC). METHODS: We extracted the data of patients with advanced HCC who underwent systemic chemotherapy using FOLFOX4 or ATRA plus FOLFOX4 at the Eastern Hepatobiliary Surgery Hospital, First Hospital of Jilin University, and Zhejiang Sian International Hospital and retrospectively compared for overall survival. The Cox proportional hazards model was used to calculate the hazard ratios for overall survival and disease progression after controlling for age, sex, and disease stage. RESULTS: From July 2013 to July 2018, 111 patients with HCC were included in this study. The median survival duration was 14.8 months in the ATRA plus FOLFOX4 group and 8.2 months in the FOLFOX4 only group ( P  < 0.001). The ATRA plus FOLFOX4 group had a significantly longer median time to progression compared with the FOLFOX4 group (3.6 months vs. 1.8 months, P  < 0.001). Hazard ratios for overall survival and disease progression were 0.465 (95% confidence interval: 0.298-0.726; P  = 0.001) and 0.474 (0.314-0.717; P  < 0.001) after adjusting for potential confounders, respectively. CONCLUSION ATRA plus FOLFOX4 significantly improves the overall survival and time to disease progression in patients with advanced HCC.
Humans ; Carcinoma, Hepatocellular/drug therapy* ; Retrospective Studies ; Liver Neoplasms/pathology* ; Oxaliplatin/therapeutic use* ; Fluorouracil/adverse effects* ; Disease Progression ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Leucovorin/adverse effects* ; Colorectal Neoplasms/drug therapy*