Effectiveness of stereotactic body radiotherapy for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombosis
PLoS One, 2013•journals.plos.org
Background To report the feasibility, efficacy, and toxicity of stereotactic body radiotherapy
(SBRT) for the treatment of portal vein tumor thrombosis (PVTT) and/or inferior vena cava
tumor thrombosis (IVCTT) in patients with advanced hepatocellular carcinoma (HCC).
Materials and methods Forty-one patients treated with SBRT using volumetric modulated arc
therapy (VMAT) for HCC with PVTT/IVCTT between July 2010 and May 2012 were analyzed.
Of these, 33 had PVTT and 8 had IVCTT. SBRT was designed to target the tumor thrombosis …
(SBRT) for the treatment of portal vein tumor thrombosis (PVTT) and/or inferior vena cava
tumor thrombosis (IVCTT) in patients with advanced hepatocellular carcinoma (HCC).
Materials and methods Forty-one patients treated with SBRT using volumetric modulated arc
therapy (VMAT) for HCC with PVTT/IVCTT between July 2010 and May 2012 were analyzed.
Of these, 33 had PVTT and 8 had IVCTT. SBRT was designed to target the tumor thrombosis …
Background
To report the feasibility, efficacy, and toxicity of stereotactic body radiotherapy (SBRT) for the treatment of portal vein tumor thrombosis (PVTT) and/or inferior vena cava tumor thrombosis (IVCTT) in patients with advanced hepatocellular carcinoma (HCC).
Materials and methods
Forty-one patients treated with SBRT using volumetric modulated arc therapy (VMAT) for HCC with PVTT/IVCTT between July 2010 and May 2012 were analyzed. Of these, 33 had PVTT and 8 had IVCTT. SBRT was designed to target the tumor thrombosis and deliver a median total dose of 36 Gy (range, 30–48 Gy) in six fractions during two weeks.
Results
The median follow-up was 10.0 months. At the time of analysis, 15 (36.6%) achieved complete response, 16 (39.0%) achieved partial response, 7 (17.1%) patients were stable, and three (7.3%) patients showed progressive disease. No treatment-related Grade 4/5 toxicity was seen within three months after SBRT. One patient had Grade 3 elevation of bilirubin. The one-year overall survival rate was 50.3%, with a median survival of 13.0 months. The only independent predictive factor associated with better survival was response to radiotherapy.
Conclusions
VMAT-based SBRT is a safe and effective treatment option for PVTT/IVCTT in HCC. Prospective randomized controlled trials are warranted to validate the role of SBRT in these patients.
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