A comparative study of treatment on portal vein tumor thrombosis in hepatocellular carcinoma with stereotactic radiotherapy versus three-dimensional conformal radiotherapy.

BACKGROUND

Portal venous tumor thrombosis (PVTT) in patients with hepatocellular carcinoma (HCC) is a poor prognostic factor, with median survival values ranging from 2 to 4 months, when untreated. Sorafenib has been used as a systemic therapy for advanced HCC patients with PVTT; however, its local effects are limited. We report the results of external beam radiotherapy for PVTT, including stereotactic radiotherapy.

METHODS

Fifty consecutive HCC patients with PVTT who underwent external beam radiotherapy were investigated at our institution between January 2004 and December 2019.

RESULTS

The median age of the patients was 71 years (range: 39-87). The patients were predominantly male (80%) who underwent three-dimensional conformal radiation therapy (82%). The Child-Pugh score was class A in 30(60%) patients and class B in 20(40%) patients. The median overall survival (OS) was 12.6 months (95% confidence interval [CI]: 7.2-18.2) and the 1-year overall survival rate for all patients was 52.3% (95% [CI]: 36.9 - 65.6). A favorable objective response rate was achieved in the stereotactic radiotherapy group (78%) compared to the three-dimensional conformal radiation therapy group (39%). Severe acute adverse events of grade 3 or higher were not observed.

CONCLUSIONS

The present study demonstrated the feasibility and efficacy of external beam radiotherapy for PVTT in patients with HCC.