Conformal radiation therapy for portal vein tumor thrombosis of hepatocellular carcinoma

Background and purposeThe prognosis of patients with portal vein tumor thrombosis (PVTT) from hepatocellular carcinoma (HCC) is poor; without treatment, their survival is less than 3 months. We retrospectively evaluated the treatment outcomes of conformal radiation therapy (CRT) in patients with HCC-PVTT.Materials and methodsThirty-eight HCC patients with PVTT in whom other treatment modalities were not indicated underwent CRT. The total dose was translated into a biologic effective dose (BED) of 23.4–59.5 Gy10 (median 50.7 Gy10) as the α/β ratio = 10. Predictive factors including the age, performance status, Child–Pugh classification, PVTT size, and BED were evaluated for tumor response and survival.ResultsComplete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) were observed in 6 (15.8%), 11 (28.9%), 17 (44.7%), and 4 (10.5%) patients, respectively. The response rate (CR + PR) was 44.7%. The PVTT size (<30 vs. ⩾30 mm) and BED (<58 vs. ⩾58 Gy10) were significant factors for tumor response. The median survival and 1-year survival rate were 9.6 months and 39.4%. The Child–Pugh classification (A vs. B) and BED were significant factors for survival.ConclusionsCRT is effective not only for tumor response but also for survival in HCC-PVTT patients in whom other treatment modalities are not indicated.