International journal of radiation oncology, biology, physics, 2012-04, Vol.82 (5), p.2004-2011
2012
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- Autor(en) / Beteiligte
- Titel
- Radiotherapy Plus Transarterial Chemoembolization for Hepatocellular Carcinoma Invading the Portal Vein: Long-Term Patient Outcomes
- Ist Teil von
- International journal of radiation oncology, biology, physics, 2012-04, Vol.82 (5), p.2004-2011
- Ort / Verlag
- New York, NY: Elsevier Inc
- Erscheinungsjahr
- 2012
- Quelle
- MEDLINE
- Beschreibungen/Notizen
- 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.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 0360-3016eISSN: 1879-355XDOI: 10.1016/j.ijrobp.2011.03.019Titel-ID: cdi_osti_scitechconnect_22056269
- Format
- –
- Schlagworte
- Adult, Aged, Aged, 80 and over, alpha-Fetoproteins - metabolism, Antineoplastic Agents - administration & dosage, Biological and medical sciences, Blood and lymphatic vessels, Carcinoma, Hepatocellular - blood, Carcinoma, Hepatocellular - mortality, Carcinoma, Hepatocellular - pathology, Carcinoma, Hepatocellular - therapy, Cardiology. Vascular system, Chemoembolization, Therapeutic - adverse effects, Chemoembolization, Therapeutic - methods, Cisplatin - administration & dosage, Combined Modality Therapy - methods, Disease-Free Survival, Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous, Ethiodized Oil - administration & dosage, Female, Gastroenterology. Liver. Pancreas. Abdomen, GY RANGE 10-100, Hematology, Oncology and Palliative Medicine, Hepatocellular carcinoma, HEPATOMAS, Humans, LIVER, Liver Neoplasms - blood, Liver Neoplasms - mortality, Liver Neoplasms - pathology, Liver Neoplasms - therapy, Liver. Biliary tract. Portal circulation. Exocrine pancreas, Male, MALES, Medical sciences, Middle Aged, Neoplasm Invasiveness, PATIENTS, Portal Vein - pathology, Portal vein tumor thrombosis, RADIATION DOSES, Radiology, RADIOLOGY AND NUCLEAR MEDICINE, RADIOTHERAPY, Radiotherapy Dosage, Radiotherapy, Conformal - adverse effects, Radiotherapy, Conformal - methods, Remission Induction - methods, Retrospective Studies, Survival Rate, THROMBOSIS, TOXICITY, Transarterial chemoembolization, Treatment Outcome, Tumors, VEINS, Venous Thrombosis - etiology, Venous Thrombosis - therapy, Young Adult