scholarly journals Stereotactic body radiotherapy combined with transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombosis

2013 ◽  
Vol 2 (1) ◽  
pp. 43-50 ◽  
Author(s):  
JINGBO KANG ◽  
QING NIE ◽  
RUI DU ◽  
LIPING ZHANG ◽  
JUN ZHANG ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Stereotactic Body Radiotherapy ◽  
Transarterial Chemoembolization ◽  
Portal Vein Tumor Thrombosis ◽  
Tumor Thrombosis

scholarly journals Transarterial chemoembolization for hepatocellular carcinoma combined with portal vein tumor thrombosis

2018 ◽  
Vol Volume 10 ◽  
pp. 4719-4726 ◽  
Author(s):  
Wei-Fu Lv ◽  
Kai-Cai Liu ◽  
Dong Lu ◽  
Chun-Ze Zhou ◽  
De-Lei Cheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Transarterial Chemoembolization ◽  
Portal Vein Tumor Thrombosis ◽  
Tumor Thrombosis

Stereotactic-body radiotherapy for portal vein tumor thrombosis in hepatocellular carcinoma patients.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 442-442
Author(s):  
Bae Kwon Jeong ◽  
Hoon Sik Choi ◽  
Ki Mun Kang ◽  
Hojin Jeong ◽  
Yun Hee Lee ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Stereotactic Body Radiotherapy ◽  
Treatment Options ◽  
Optimal Dose ◽  
Portal Vein Tumor Thrombosis ◽  
Hepatic Toxicity ◽  
Effective Treatment Option ◽  
Tumor Thrombosis ◽  
Grade 3

442 Background: Portal vein tumor thrombosis (PVTT) is commonly accompanied by hepatocellular carcinoma (HCC) patients, and in these cases the treatment options became limited and treatment outcome was poor. Stereotactic body radiotherapy (SBRT) is one of the possible treatment options, which can deliver higher doses with highly conformal target have conducted for treatment of PVTT. However, only few studies about the SBRT have reported, even treatment schedules were not consistent. In this study, we report our institutional experience of treating PVTT in HCC patients using SBRT. Methods: 24 HCC patients with PVTT were treated with SBRT at our institution. All patients had unresectable HCC with PVTT, baseline liver function of Child-Pugh class A or B. SBRT was performed by Cyberknife based on 4D-simulation and 4D-planning. The prescription dose was 45 Gy in 3 fractions in 17 (70.8%) patients, and was modified to 39 to 42 Gy in 3 to 4 fractions in 7 (29.2%) patients whose target was large or adjacent to the bowel. After SBRT, transarterial chemoembolization (TACE) was performed in 16 (66.7%) patients within 3 months. Results: There were 2 (8.3%) patients of PVTT showed complete response, and 11 (45.8%) patients showed partial response. Stable disease was found in 7 (29.2%) patients, and progression in 4 (16.7%) patients. The response rate was lower in patients with tumor thrombus at main portal vein than those at branch of portal vein (main, 30% vs. branch, 71.4%, p = 0.052). The 1- and 2-year overall survival (OS) was 67.5%, 48.2%, respectively, with median survival of 20.8 months. The combination SBRT followed by TACE, and presence of grade 3 hepatic toxicities impacted on survival. The 1-year OS was 71.4% in patients whom TACE was combined after SBRT, which was higher than that of 14.6% who were treated with SBRT alone (p < 0.001). The 1-year OS was 81.1% in patients who did not occur grade 3 hepatic toxicity, while 0% in patients who had grade 3 hepatic toxicity (p = 0.002). Conclusions: SBRT is a relatively effective treatment option for HCC patients of PVTT. Especially combined with TACE. Finding an optimal dose schedule which can reduce hepatic toxicity, while keeping the response seems important to increase the survival.

scholarly journals Transarterial Chemoembolization for the Treatment of Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: Prognostic Factors in a Single-Center Study of 188 Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Lei Liu ◽  
Cheng Zhang ◽  
Yan Zhao ◽  
Xingshun Qi ◽  
Hui Chen ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Portal Vein ◽  
Transarterial Chemoembolization ◽  
Cox Regression ◽  
Advanced Hepatocellular Carcinoma ◽  
Portal Vein Tumor Thrombosis ◽  
Cox Regression Analysis ◽  
Tumor Thrombosis ◽  
Pugh Class

Transarterial chemoembolization (TACE) could achieve a better survival benefit than conservative treatment for advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). In this retrospective study, all HCC patients with Child-Pugh score <7 and PVTT who were consecutively admitted to our center between January 2006 and June 2012 and underwent TACE were enrolled. The efficacy and safety of TACE were analyzed. Prognostic factors were determined by Cox regression analysis. Of the 188 patients included, 89% had hepatitis B virus infection, 100% were at Barcelona Clinic Liver Cancer stage C, and 81% (n=152) and 19% (n=36) were at Child-Pugh classes A and B, respectively. The incidence of procedure-related complications was 88%. No procedure-related death was found. The median overall survival was 6.1 months. Type of PVTT (hazard ratio [HR] = 2.806), number of tumor lesions (HR = 2.288), Child-Pugh class (HR = 2.981), and presence of metastasis (HR = 1.909) were the independent predictors of survival. In conclusion, TACE could be selectively used for the treatment of advanced HCC with PVTT. But a high rate of postoperative adverse events should not be undermined in spite of no procedure-related death. Preoperative type of PVTT, number of tumor lesions, Child-Pugh class, and metastasis could predict the prognosis of these patients.

scholarly journals Stereotactic Body Radiotherapy Versus Intensity-Modulated Radiotherapy For Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis

2021 ◽  
Author(s):  
Liqing Li ◽  
Ying Zhou ◽  
Yong Huang ◽  
Ping Liang ◽  
Shixiong Liang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Stereotactic Body Radiotherapy ◽  
Intensity Modulated Radiotherapy ◽  
Advanced Hepatocellular Carcinoma ◽  
Portal Vein Tumor Thrombosis ◽  
Efficient Treatment ◽  
Tumor Thrombosis ◽  
Intensity Modulated ◽  
Significant Difference

Abstract Background: It is unclear whether robotic stereotactic body radiotherapy (SBRT) is superior to intensity-modulated radiotherapy (IMRT) in advanced hepatocellular carcinoma (HCC). This study aimed to compare the long-term outcomes of SBRT with those of IMRT in HCCs with portal vein tumor thrombosis (PVTT). Methods: We retrospectively evaluated 287 HCC patients with PVTT who underwent radiotherapy between January 2000 and January 2017. Of them, 154 and 133 patients were treated with IMRT and SBRT, respectively. Overall survival (OS), progression-free survival (PFS), intrahepatic control (IC), and local control (LC) were evaluated in univariable and propensity-score matched analyses. Results: After matching, 102 well-paired patients were selected. There was no significant difference in the 6-, 12-, 24-, and 60-month cumulative OS (73.5, 42.9, 23.6, 7.6% vs. 72.4, 45.1, 29.8, 13.2%, P=0.151), PFS (53.9, 29.3, 21.8, 7.5% vs. 54.5, 19.3, 12.0, 9.6%, P=0.744) , IC (61.4, 45.7, 39.0, 26.8% vs. 75.1, 45.8, 35.9, 28.7%, P=0.144), and LC (85.2, 56.5, 52.1, 47.4% vs. 87.4, 65.2, 62.1, 62.1%, P=0.191) between the IMRT and SBRT groups. A biologically effective dose assumed at an a/b ratio of 10 (BED10) of ≥100 Gy was the optimal cutoff for predicting the OS, PFS, IC, and LC in the patients who received SBRT. Conclusions: When high-precision tracking technology is available, SBRT appears to be a safe and more time-efficient treatment, achieving comparable OS, PFS, IC and LC to IMRT for local advanced HCC with PVTT. A BED10≥100 Gy is recommended if tolerated by normal tissue.

scholarly journals Transarterial chemoembolization in hepatocellular carcinoma with portal vein tumor thrombosis: a systematic review and meta-analysis

HPB ◽  
2017 ◽  
Vol 19 (8) ◽  
pp. 659-666 ◽  
Author(s):  
Jack P. Silva ◽  
Nicholas G. Berger ◽  
Susan Tsai ◽  
Kathleen K. Christians ◽  
Callisia N. Clarke ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Portal Vein ◽  
Transarterial Chemoembolization ◽  
Meta Analysis ◽  
Portal Vein Tumor Thrombosis ◽  
Tumor Thrombosis
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