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Radiotherapeutic strategies for hepatocellular carcinoma with portal vein tumour thrombosis in a hepatitis B endemic area

 Jung Ho Im  ;  Sang Min Yoon  ;  Hee Chul Park  ;  Jong Hoon Kim  ;  Jeong Il Yu  ;  Tae Hyun Kim  ;  Jun Won Kim  ;  Taek-Keun Nam  ;  Kyubo Kim  ;  Hong Seok Jang  ;  Jin Hee Kim  ;  Mi-Sook Kim  ;  Won Sup Yoon  ;  Inkyung Jung  ;  Jinsil Seong 
 LIVER INTERNATIONAL, Vol.37(1) : 90-100, 2017 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/complications* ; Carcinoma, Hepatocellular/radiotherapy* ; Combined Modality Therapy ; Female ; Hepatitis B/epidemiology ; Humans ; Kaplan-Meier Estimate ; Korea ; Liver Neoplasms/complications* ; Liver Neoplasms/radiotherapy* ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Portal Vein/pathology ; Propensity Score ; Radiation Dosage ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Venous Thrombosis/radiotherapy* ; Young Adult
combined modality therapy ; hepatocellular carcinoma ; portal vein tumour thrombosis ; radiotherapy ; radiotherapy dosage
BACKGROUND & AIMS: This nationwide, multicenter study investigated treatment outcomes as well as the optimal radiotherapeutic strategy in patients with hepatocellular carcinoma (HCC) and portal vein tumour thrombosis (PVTT). METHODS: We retrospectively reviewed the records of 985 patients who received radiotherapy (RT) for PVTT. The median equivalent RT dose was 48.75 Gy. Combined treatment, defined as liver-directed treatments performed within a month of RT, was administered to 657 patients (66.7%). The PVTT and primary tumour were irradiated in 413 patients (41.9%), and PVTT only was targeted in 572 patients (58.1%). RESULTS: The response rate of the PVTT was 51.8%, and RT responders had a significantly longer survival than non-responders (15.2 vs. 6.9 months). Equivalent RT dose and combined treatment predicted response of PVTT. The median overall survival (OS) was 10.2 months. Multivariate analysis revealed the equivalent RT dose ˃45 Gy and combined treatment as significant positive factors for OS. In the propensity score matching analysis, the combined treatment group had better OS than the no combined treatment group, whereas the OS of the PVTT + primary tumour group did not differ significantly from that of the PVTT only group. CONCLUSION: The equivalent RT dose ˃45 Gy, given in combination with other treatments, provided better PVTT control and OS. The optimal RT volume is suggested for either PVTT + primary or PVTT only. Taken together, multimodal treatment with equivalent RT dose higher than 45 Gy is recommended for patients with HCC and PVTT.
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1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Im, Jung Ho(임정호)
Jung, Inkyung(정인경) ORCID logo https://orcid.org/0000-0003-3780-3213
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