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J Korean Soc Ther Radiol Oncol > Volume 25(3); 2007 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2007;25(3): 170-176.
The Role of Radiotherapy in the Treatment of Portal Vein Thrombosis from Advanced Hepatocellular Carcinoma
Jung Hoon Kim, Eun Kyung Choi, Seung Do Ahn, Sang Wook Lee, Seong Soo Shin, Wonsik Choi, Young Suk Lim, Kang Mo Kim, Dong Jin Suh, Young Wha Chung, Young Sang Lee, Hyung Jin Won, Jong Hoon Kim
1Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jhkim2@amc.seoul.kr
2Department of Gasteroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
3Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
ABSTRACT
PURPOSE:
To determine the role of radiotherapy for the treatment of portal vein thrombosis (PVT) from hepatocellular carcinoma (HCC). MATERIAL AND
METHODS:
A retrospective analysis was performed on 70 patients that had been diagnosed with HCC and were treated with three-dimensional conformal radiotherapy (3D-CRT) for the PVT. The radiation dose ranged from 40 Gy to 60 Gy (median dose: 48 Gy) and the biological effective dose (BED) ranged from 31.3 Gy to 78.0 Gy10 (median dose: 61.6 Gy10). Response was determined by measuring the extent of the PVT on a CT image at 0, 1 and 3 months after completion of the radiotherapy. The median follow-up period was 9 months.
RESULTS:
The response rate was 47.1% (33 patients), with two patients (2.9%) showing a complete response, 31 patients (44.3%) showing a partial response, and 35 patients (50%) showing stable disease or no response. The 1-year progression-free survival rate was 60%, and the median progression-free survival time was 17 months. The median overall survival time was 11 months, the median survival time in the responders was 15 months and in the nonresponders was 8 months (p=0.032). Four patients (5.7%) had transient liver function impairment during treatment. Radiation induced liver disease (RILD) was observed in only one patient (1.4%).
CONCLUSION:
Three-dimensional conformal radiotherapy for the treatment of PVT from advanced HCC was a relatively effective and safe method.
Key Words: Portal vein thrombosis, Hepatocellular carcinoma, Three-dimensional conformal radiotherapy
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