Radiation therapy for portal venous invasion by hepatocellular carcinoma

Keiichi Nakagawa, Hideomi Yamashita, Kenshiro Shiraishi, Naoki Nakamura, Masao Tago, Hiroshi Igaki, Yoshio Hosoi, Shuichiro Shiina, Masao Omata, Masatoshi Makuuchi, Kuni Ohtomo

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39 Citations (Scopus)

Abstract

Aim: To clarify the efficacy and safety of three-dimensional conformal radiotherapy (3-D CRT) for this disease and to specify patient subgroups suitable for this treatment. Methods: Fifty-two patients with HCC received PVI-targeted radiation therapy from January 1995 through December 2003. Portal venous invasion (PVI) was found in the second or lower order branches of the portal vein in 6 patients, in the first branch in 24 patients and in the main trunk in 22 patients. Child classifications of liver function before radiation therapy were A, B, and C for 19, 24 and 2 patients, respectively. All patients received three-dimensional conformal radiotherapy with a total dose ranging from 39 to 60 Gy (57.0 Gy in average). Results: Overall survival rates at 1, 2, 3, 4, and 5 years were 45.1%, 25.3%, 15.2%, 10.1%, and 5.1%, respectively. Univariate analysis revealed that Child status, the number of tumor foci, tumor type, transcatheter arterial embolization (TAE) after radiation therapy were statistically significant prognostic factors. Multivariate analysis showed that the number of tumor foci and TAE after radiation therapy were statistically significant. Conclusion: The results of this study strongly suggest the efficacy of 3-D CRT as treatment for PVI in HCC. 3-D CRT is recommended in combination with post-radiation TAE for PVI of HCC with 5 tumor foci or less in the liver and with Child A liver function.

Original languageEnglish
Pages (from-to)7237-7241
Number of pages5
JournalWorld Journal of Gastroenterology
Volume11
Issue number46
DOIs
Publication statusPublished - 2005 Dec 14
Externally publishedYes

Keywords

  • Hepatocellular carcinoma
  • Portal venous invasion
  • Radiation therapy

ASJC Scopus subject areas

  • Gastroenterology

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    Nakagawa, K., Yamashita, H., Shiraishi, K., Nakamura, N., Tago, M., Igaki, H., Hosoi, Y., Shiina, S., Omata, M., Makuuchi, M., & Ohtomo, K. (2005). Radiation therapy for portal venous invasion by hepatocellular carcinoma. World Journal of Gastroenterology, 11(46), 7237-7241. https://doi.org/10.3748/wjg.v11.i46.7237