Volume 5, Issue 3, September 2020, Page: 65-77
Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study
Takuya Nagano, Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
Akihiko Hoshi, Department of Radiology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Masayuki Kurosaki, Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Kazuma Sasamura, Department of Radiation Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
Kaoru Tsuchiya, Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Kazuma Toda, Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
Hirofumi Kuwabara, Department of Radiology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Meika Namba, Department of Radiology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Daigoro Matsubara, Department of Radiology, Asahi General Hospital, Asahi-shi, Chiba, Japan
Sayako Oota, Department of Radiology, Asahi General Hospital, Asahi-shi, Chiba, Japan
Yasuo Yoshioka, Department of Radiation Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
Ryoichi Yoshimura, Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
Namiki Izumi, Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Received: Sep. 16, 2020;       Accepted: Sep. 27, 2020;       Published: Oct. 7, 2020
DOI: 10.11648/j.ijcocr.20200503.13      View  28      Downloads  30
Abstract
Background: The aim of this multicenter study was to evaluate the outcome of radiotherapy (RT) that targeted for tumor thrombi (TT) from hepatocellular carcinoma (HCC), including the portal vein, hepatic vein, inferior vena cava, and bile duct TT. Methods: Patients who received RT for the treatment of TT between 2005 and 2020 were retrospectively reviewed. We compared patient characteristics, overall survival (OS), the combined chemotherapy regimen, and objective response rates (ORRs) between the treatment modalities and analyzed cumulative incidence formula (CIF) for the deterioration in the Child-Pugh class and the progression of intrahepatic tumors. Results: We evaluated 64 patients, 39 of whom received combined chemotherapy with RT. Multivariate analysis showed that the Child-Pugh class, primary tumor size and the response of TT were significant prognostic factors for OS and the total equivalent dose in 2 Gy fractions (EQD2) of more than 48.75 Gy significantly contributed to ORRs (p=0.04). In the multivariate analysis of CIF, only acute liver damage was the significant factor for the deterioration in the Child-Pugh class (p=0.01) and the length of TT was significant for the progression of intrahepatic tumors (p=0.03). Conclusion: High doses should be delivered to TT, but long tumor thrombi are difficult to control. Tumor thrombus length is more important in predicting intrahepatic progression than the location of the tumor thrombus.
Keywords
Combined Chemotherapy, Radiation Therapy, Hepatocellular Carcinoma, Macroscopic Vascular Invasion, Tumor Thrombosis
To cite this article
Takuya Nagano, Akihiko Hoshi, Masayuki Kurosaki, Kazuma Sasamura, Kaoru Tsuchiya, Kazuma Toda, Hirofumi Kuwabara, Meika Namba, Daigoro Matsubara, Sayako Oota, Yasuo Yoshioka, Ryoichi Yoshimura, Namiki Izumi, Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study, International Journal of Clinical Oncology and Cancer Research. Vol. 5, No. 3, 2020, pp. 65-77. doi: 10.11648/j.ijcocr.20200503.13
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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