Radiotherapy Plus Transarterial Chemoembolization for Hepatocellular Carcinoma Invading the Portal Vein: Long-Term Patient Outcomes
Abstract
Purpose: We have evaluated the clinical outcomes of patients after transarterial chemoembolization (TACE) and 3-dimensional conformal radiotherapy for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Methods and Materials: A registry database of 412 patients treated with TACE and three-dimensional conformal radiotherapy for HCC with PVTT between August 2002 and August 2008 were analyzed retrospectively. The radiotherapy volume included the PVTT, with a 2- to 3-cm margin to cover adjacent HCC. Intrahepatic primary HCC was managed by TACE before or after radiotherapy. Results: Median patient age was 52 years old, and 88.1% of patients were male. Main or bilateral PVTT was observed in 200 (48.5%) patients. Median radiation dose was 40 Gy (range, 21-60 Gy) delivered in 2- to 5-Gy fractions. We found that 3.6% of patients achieved a complete response and that 24.3% of patients achieved a partial response. The response and progression-free rates of PVTT were 39.6% and 85.6%, respectively. Median patient survival was 10.6 months, and the 1- and 2-year survival rates were 42.5% and 22.8%, respectively. Significant independent variables associated with overall survival included advanced tumor stage, alpha-fetoprotein level, degree of PVTT, and response to radiotherapy. Forty-one patients (10.0%) showed grade 3-4 hepatic toxicity duringmore »
- Authors:
-
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)
- Publication Date:
- OSTI Identifier:
- 22056269
- Resource Type:
- Journal Article
- Journal Name:
- International Journal of Radiation Oncology, Biology and Physics
- Additional Journal Information:
- Journal Volume: 82; Journal Issue: 5; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
- Subject:
- 62 RADIOLOGY AND NUCLEAR MEDICINE; GY RANGE 10-100; HEPATOMAS; LIVER; MALES; PATIENTS; RADIATION DOSES; RADIOTHERAPY; THROMBOSIS; TOXICITY; VEINS
Citation Formats
Yoon, Sang Min, Lim, Young-Suk, Won, Hyung Jin, Kim, Jong Hoon, E-mail: jhkim2@amc.seoul.kr, Kim, Kang Mo, Lee, Han Chu, Chung, Young-Hwa, Lee, Yung Sang, Lee, Sung Gyu, Park, Jin-hong, and Suh, Dong Jin. Radiotherapy Plus Transarterial Chemoembolization for Hepatocellular Carcinoma Invading the Portal Vein: Long-Term Patient Outcomes. United States: N. p., 2012.
Web. doi:10.1016/J.IJROBP.2011.03.019.
Yoon, Sang Min, Lim, Young-Suk, Won, Hyung Jin, Kim, Jong Hoon, E-mail: jhkim2@amc.seoul.kr, Kim, Kang Mo, Lee, Han Chu, Chung, Young-Hwa, Lee, Yung Sang, Lee, Sung Gyu, Park, Jin-hong, & Suh, Dong Jin. Radiotherapy Plus Transarterial Chemoembolization for Hepatocellular Carcinoma Invading the Portal Vein: Long-Term Patient Outcomes. United States. https://doi.org/10.1016/J.IJROBP.2011.03.019
Yoon, Sang Min, Lim, Young-Suk, Won, Hyung Jin, Kim, Jong Hoon, E-mail: jhkim2@amc.seoul.kr, Kim, Kang Mo, Lee, Han Chu, Chung, Young-Hwa, Lee, Yung Sang, Lee, Sung Gyu, Park, Jin-hong, and Suh, Dong Jin. 2012.
"Radiotherapy Plus Transarterial Chemoembolization for Hepatocellular Carcinoma Invading the Portal Vein: Long-Term Patient Outcomes". United States. https://doi.org/10.1016/J.IJROBP.2011.03.019.
@article{osti_22056269,
title = {Radiotherapy Plus Transarterial Chemoembolization for Hepatocellular Carcinoma Invading the Portal Vein: Long-Term Patient Outcomes},
author = {Yoon, Sang Min and Lim, Young-Suk and Won, Hyung Jin and Kim, Jong Hoon, E-mail: jhkim2@amc.seoul.kr and Kim, Kang Mo and Lee, Han Chu and Chung, Young-Hwa and Lee, Yung Sang and Lee, Sung Gyu and Park, Jin-hong and Suh, Dong Jin},
abstractNote = {Purpose: We have evaluated the clinical outcomes of patients after transarterial chemoembolization (TACE) and 3-dimensional conformal radiotherapy for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Methods and Materials: A registry database of 412 patients treated with TACE and three-dimensional conformal radiotherapy for HCC with PVTT between August 2002 and August 2008 were analyzed retrospectively. The radiotherapy volume included the PVTT, with a 2- to 3-cm margin to cover adjacent HCC. Intrahepatic primary HCC was managed by TACE before or after radiotherapy. Results: Median patient age was 52 years old, and 88.1% of patients were male. Main or bilateral PVTT was observed in 200 (48.5%) patients. Median radiation dose was 40 Gy (range, 21-60 Gy) delivered in 2- to 5-Gy fractions. We found that 3.6% of patients achieved a complete response and that 24.3% of patients achieved a partial response. The response and progression-free rates of PVTT were 39.6% and 85.6%, respectively. Median patient survival was 10.6 months, and the 1- and 2-year survival rates were 42.5% and 22.8%, respectively. Significant independent variables associated with overall survival included advanced tumor stage, alpha-fetoprotein level, degree of PVTT, and response to radiotherapy. Forty-one patients (10.0%) showed grade 3-4 hepatic toxicity during or 3 months after completion of radiotherapy. Grades 2-3 gastroduodenal complications were observed in 15 patients (3.6%). Conclusions: Radiotherapy is a safe and effective treatment for PVTT in patients with HCC. These results suggested that the combination of TACE and radiotherapy is a treatment option for relieving and/or stabilizing PVTT in patients with advanced HCC.},
doi = {10.1016/J.IJROBP.2011.03.019},
url = {https://www.osti.gov/biblio/22056269},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 82,
place = {United States},
year = {Sun Apr 01 00:00:00 EDT 2012},
month = {Sun Apr 01 00:00:00 EDT 2012}
}