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Title: 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 » 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.« less

Authors:
 [1];  [2];  [3]; ; ; ;  [2];  [4];  [1];  [2]
  1. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)
  2. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)
  3. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)
  4. 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}
}