Sae Rom Chung1, Jin Hyoung Kim2, Hyun-Ki Yoon1, Gi-Young Ko1, Dong Il Gwon1, Ji Hoon Shin1, Ho-Young Song1, Heung Kyu Ko1, Sang Min Yoon3. 1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea. 2. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea. Electronic address: jhkimrad@amc.seoul.kr. 3. Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Song pa-gu, Seoul 138-736, Republic of Korea.
Abstract
PURPOSE: To evaluate the safety and survival outcome of chemoembolization plus radiation therapy (RT) in patients with hepatocellular carcinoma (HCC) with main portal vein (PV) tumor thrombosis. MATERIALS AND METHODS: This retrospective study evaluated 151 patients with HCC and main PV involvement (101 with Child-Pugh class A liver function and 50 with Child-Pugh class B liver function) treated with combined cisplatin-based chemoembolization and RT. Medical records, imaging, and laboratory studies were reviewed, and complications, survival, and mortality rates were determined. RESULTS: After chemoembolization, major complications occurred in 19.9% of patients, with the rate of major complications significantly higher in Child-Pugh class B cases than in Child-Pugh class A cases (32% vs 13.9%; P = .016). The 30-day mortality rate was 0.7%. One hundred forty-seven patients received adjuvant RT an average of 17.4 days after chemoembolization for main PV tumor thrombosis. Adjuvant RT could not be performed in four patients because of intolerance of the initial chemoembolization. There were no major complications after RT. The objective tumor response at 6 months was 25.2%, with a median survival of 12 months (14 mo in Child-Pugh class A cases and 8 mo in Child-Pugh class B cases). Patients with Child-Pugh class B liver function with extrahepatic metastases, no tumor response, and absence of second-line sorafenib treatment had poor survival. CONCLUSIONS: Chemoembolization combined with RT improves survival, with a median survival of 12 months in patients with HCC with main PV involvement.
PURPOSE: To evaluate the safety and survival outcome of chemoembolization plus radiation therapy (RT) in patients with hepatocellular carcinoma (HCC) with main portal vein (PV) tumor thrombosis. MATERIALS AND METHODS: This retrospective study evaluated 151 patients with HCC and main PV involvement (101 with Child-Pugh class A liver function and 50 with Child-Pugh class B liver function) treated with combined cisplatin-based chemoembolization and RT. Medical records, imaging, and laboratory studies were reviewed, and complications, survival, and mortality rates were determined. RESULTS: After chemoembolization, major complications occurred in 19.9% of patients, with the rate of major complications significantly higher in Child-Pugh class B cases than in Child-Pugh class A cases (32% vs 13.9%; P = .016). The 30-day mortality rate was 0.7%. One hundred forty-seven patients received adjuvant RT an average of 17.4 days after chemoembolization for main PV tumor thrombosis. Adjuvant RT could not be performed in four patients because of intolerance of the initial chemoembolization. There were no major complications after RT. The objective tumor response at 6 months was 25.2%, with a median survival of 12 months (14 mo in Child-Pugh class A cases and 8 mo in Child-Pugh class B cases). Patients with Child-Pugh class B liver function with extrahepatic metastases, no tumor response, and absence of second-line sorafenib treatment had poor survival. CONCLUSIONS: Chemoembolization combined with RT improves survival, with a median survival of 12 months in patients with HCC with main PV involvement.
Authors: Jonggi Choi; Danbi Lee; Ju Hyun Shim; Kang Mo Kim; Young-Suk Lim; Yung Sang Lee; Han Chu Lee Journal: PLoS One Date: 2020-03-04 Impact factor: 3.240
Authors: Lei Chen; Tao Sun; Xuefeng Kan; Shi Chen; Yanqiao Ren; Yanyan Cao; Liangliang Yan; Bin Liang; Bin Xiong; Chuansheng Zheng Journal: J Int Med Res Date: 2020-10 Impact factor: 1.671