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Pilot clinical trial of localized concurrent chemoradiation therapy for locally advanced hepatocellular carcinoma with portal vein thrombosis.

 Kwang-Hyub Han  ;  Jinsil Seong  ;  Ja Kyung Kim  ;  Sang Hoon Ahn  ;  Do Yun Lee  ;  Chae Yoon Chon 
 CANCER, Vol.113(5) : 995-1003, 2008 
Journal Title
Issue Date
Adult ; Aged ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/drug therapy* ; Carcinoma, Hepatocellular/radiotherapy* ; Combined Modality Therapy/adverse effects ; Disease Progression ; Female ; Humans ; Infusions, Intra-Arterial ; Liver Neoplasms/complications ; Liver Neoplasms/drug therapy* ; Liver Neoplasms/radiotherapy* ; Male ; Middle Aged ; Pilot Projects ; Portal Vein* ; Venous Thrombosis/etiology*
hepatocellular carcinoma ; thrombosis ; radiotherapy ; combinedmodality therapy
BACKGROUND: Patients with advanced hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) have a particularly grave prognosis. In the current study, an attempt was made to localize chemoradiation therapy (CCRT) followed by hepatic arterial infusion chemotherapy (HAIC) in patients with locally advanced HCC with PVT and good reserve liver function. The objective of the current study was to evaluate the therapeutic effect of localized CCRT followed by HAIC as a new treatment modality for these patients.

METHODS: Between January 1998 and December 2003, 40 patients were recruited. Concurrent regional chemotherapy using an intra-arterial implanted port plus localized external beam radiotherapy was performed with a total of 45 gray (Gy) over 5 weeks with conventional fractionation and hepatic arterial infusion of 5-fluorouracil (5-FU), which was administered during the first and fifth weeks of radiotherapy. One month after localized CCRT, HAIC with 5-FU and cisplatin was administered every 4 weeks.

RESULTS: One month after localized CCRT, an objective response was observed on the intention-to-treat analysis in 18 of 40 patients (45%). The actuarial 3-year overall survival rate was 24.1% and the median survival time was 13.1 months from the start of radiation treatment. Responders after localized CCRT demonstrated significantly better survival (P = .033) than nonresponders.

CONCLUSIONS: The substantial response rate as well as median survival time noted in the current study encourages the use of this new approach in patients with locally advanced HCC with PVT.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ja Kyung(김자경) ORCID logo https://orcid.org/0000-0001-5025-6846
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Do Yun(이도연)
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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