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Radiation therapy in combination with transcatheter arterial chemoembolization for hepatocellular carcinoma with extensive portal vein involvement
Author(s) -
Tazawa Junichi,
Maeda Manabu,
Sakai Yoshinori,
Yamane Michio,
Ohbayashi Hideo,
Kakinuma Sei,
Miyasaka Yuka,
Nagayama Kazuyoshi,
Enomoto Nobuyuki,
Sato Chifumi
Publication year - 2001
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2001.02496.x
Subject(s) - medicine , hepatocellular carcinoma , transcatheter arterial chemoembolization , epirubicin , radiation therapy , liver function , radiology , combination therapy , gastroenterology , response evaluation criteria in solid tumors , embolization , progressive disease , chemotherapy , cyclophosphamide
Aim: The aim of this study was to examine the effectiveness and toxicity of radiation therapy in combination with transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) with extensive portal vein tumor thrombus (PVTT). Methods: The combined therapy was performed in 24 HCC patients with extensive PVTT. External radiation targeted for PVTT (50 Gy in 2 Gy fractions) was performed in combination with repetitive TACE for intralobar lesions using 30–60 mg epirubicin every 3 months, and associations of the following variables with the survival rate were evaluated: gender, age, viral etiology, Child’s class, performance status, extrahepatic metastasis, size and number of HCC, and location of PVTT. Results: The local response confined to PVTT was complete response (CR) in four patients, partial response (PR) in eight patients, no change (NC) in eight patients, and progressive disease (PD) in four patients. By using the stepwise Cox’s regression analysis, only Child’s class was associated with the survival rate. The survival rates after 1 and 2 years were 73 and 21% in Child’s A, 10 and 0% in Child B or C, and 61 and 21% in patients in whom the local response was CR or PR, and 19 and 9% in those in whom the local response was NC or PD, respectively. By using the multiple logistic regression analysis, Child’s class was the only factor associated with the local response ( P = 0.006). Conclusions: The combined therapy is feasible and may be useful to reverse PVTT in patients with good hepatic function reserve.