Comparison of Outcome of Hepatic Arterial Infusion Chemotherapy Combined with Radiotherapy and Sorafenib for Advanced Hepatocellular Carcinoma Patients with Major Portal Vein Tumor Thrombosis

Kodama, Kenichiro; Kawaoka, Tomokazu; Uchikawa, Shinsuke; Nishida, Yuno; Inagaki, Yuki; Hatooka, Masahiro; Morio, Kei; Nakahara, Takashi; Murakami, Eisuke; Tsuge, Masataka; Hiramatsu, Akira; Kawakami, Yoshiiku; Kitajima, Masaki; Honda, Yoji; Mori, Nozomu; Takaki, Shintaro; Tsuji, Keiji; Kohno, Hirotaka; Kohno, Hiroshi; Moriya, Takuya; Nonaka, Michihiro; Hyogo, Hideyuki; Aisaka, Yasuyuki; Kimura, Tomoki; Nagata, Yasushi; Chayama, Kazuaki

doi:10.1159/000486483

Cited by 41 publications

(42 citation statements)

References 28 publications

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“…The incidence of portal vein tumor thrombus (PVTT) or hepatic vein tumor thrombus (HVTT) has been reported to be 44–62.2% or 1.4–4.9%, respectively, in patients with HCC . Both are poor prognostic factors for HCC patients . Due to the low incidence of HVTT compared with PVTT, knowledge on HVTT is limited.…”

Section: Introductionmentioning

confidence: 99%

Liver resection versus transcatheter arterial chemoembolization for the treatment of patients with hepatocellular carcinoma and hepatic vein or inferior vena cava tumor thrombus: A propensity score matching analysis

Chen

Zhang

Wang

et al. 2019

Hepatology Research

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Aim: Because of the rarity of hepatic vein tumor thrombus (HVTT) in patients with hepatocellular carcinoma (HCC), little is known about HVTT. Thus, the survival benefit of liver resection (LR) versus transcatheter arterial chemoembolization (TACE) for HCC patients with HVTT or inferior vena cava tumor thrombus (IVCTT) remains controversial. We aimed to explore the survival benefits of LR versus TACE for the treatment of these patients.Methods: From 2012 to 2016, a total of 276 patients with HVTT or IVCTT who underwent liver resection or TACE were enrolled in this study. Patients in the LR group were matched at a 1:1 ratio with patients treated with TACE as an initial treatment (TACE group). Clinical characteristics, overall survival, and diseasefree survival were analyzed. Results:The median survival time in the LR group was 4.7 months longer than that in the TACE group before PSM (19.4 vs. 14.7 months, P = 0.006) and 6.9 months longer than that in the TACE group after PSM (20.9 vs. 14.0 months, P = 0.019). The median disease-free survival time in the LR group was 3.2 months longer than that in the TACE group before PSM (12.3 vs. 9.1 months, P = 0.038) and 5.8 months longer than that in the TACE group after PSM (13.0 vs. 7.2 months, P = 0.011). Conclusion:Liver resection provides a good prognosis for HCC patients with HVTT or IVCTT compared with patients undergoing TACE, and coexistence with portal vein tumor thrombus is the most important factor related to survival. Figure 1 Flowchart of screening hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (HVTT) or inferior vena cava tumor thrombus (IVCTT) undergoing hepatic resection (HR) or transcatheter chemoembolization (TACE).

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Section: Introductionmentioning

confidence: 99%

Liver resection versus transcatheter arterial chemoembolization for the treatment of patients with hepatocellular carcinoma and hepatic vein or inferior vena cava tumor thrombus: A propensity score matching analysis

Chen

Zhang

Wang

et al. 2019

Hepatology Research

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“…The result of LC shown in that study was similar to that in our study, although all patients analyzed had locally advanced disease cases. For various LAHCC treatments, median OS in molecular targeted therapy ranged between 5.3 and 11.5 months [3][4][5]21], while that in hepatic arterial infusion chemotherapy with radiotherapy was 9.9 months [21], and that in TACE-based multidisciplinary treatment ranged from 7.0 to 12.7 months [5,22], and the 3-year OS rates in surgery based multidisciplinary treatment ranged from 13 to 68% [15,[23][24]. Additionally, Komatsu et al reported on the clinical outcomes comparison in LAHCC between particle therapy and liver resection in a matched-pair analysis [25].…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of Hypofractionated Carbon Ion Radiotherapy on Locally Advanced Hepatocellular Carcinoma

Shiba

Shibuya

Okamoto

et al. 2020

Preprint

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Background: Hepatocellular carcinoma (HCC) involving a major branch of the portal or hepatic vein is in a locally advanced stage and remains difficult to cure. This study aimed to evaluate the clinical effects of carbon ion radiotherapy (C-ion RT) in locally advanced HCC (LAHCC). Methods: The data of 11 consecutive patients with LAHCC who received C-ion RT were analyzed. The C-ion RT doses of 52.8 Gy (relative biological effectiveness [RBE]) and 60.0 Gy (RBE) were delivered in 4 fractions for standard cases, and the 60.0 Gy dose was delivered in 12 fractions for close-to-gastrointestinal-tract cases. Survival and local control probabilities were calculated using the Kaplan-Meier method. Results: The median follow-up duration after C-ion RT was 36.4 months. The median age at the time of registration for C-ion RT was 76 years. The median tumor size was 53 mm. The numbers of treatment-naive and recurrent HCC patients were 1 and 10, respectively. Direct invasion of the major branch of the portal vein, hepatic vein, or both portal and hepatic veins was observed in three, five, and three patients, respectively. The 3-year overall survival, local control, and progression-free survival rates were 64%, 78%, and 18%, respectively. No patient developed radiation-induced liver diseases or grade 3 or higher toxicities in the acute and late phases. Conclusions: C-ion RT showed favorable clinical outcomes with a high rate of local control and minimal toxicities in LAHCC. Our findings suggest that C-ion RT is a promising multidisciplinary treatment option in LAHCC.

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“…Update results of a study on patients with advanced HCC who had portal vein thrombosis revealed that survival was significantly longer in patients treated with hepatic arterial infusion of chemotherapy + RT than with sorafenib monotherapy [23].…”

Section: Discussionmentioning

confidence: 99%

Concomitant Chemoradiation Using Gemcitabine in Locally Advanced Hepatocellular Carcinoma

Mohamed¹

2018

JCT

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Purpose: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Most of patients present with advanced disease that cannot be treated with curative or ablative intent. The aim of the study was to assess the therapeutic benefit of concurrent chemoradiotherapy (CCRT) in patients with advanced HCC and to identify factors that predict OS. Methods: Patients with radiologically or biopsy proven primary HCC from 2010 to 2013 were included in the study. Gemcitabine was given in a dose of 70 mg/m 2 once weekly for three weeks during external beam radiotherapy 30 Gy/2 Gy/fraction/five fractions per week in the Clinical Oncology Department, Assiut, Egypt. Results: Forty-nine patients were eligible but forty patients were evaluable for assessment. The partial response rate (PR) was 35% (14 patients), 16 patients (40%) had stable disease (SD) and the progressive disease was 25%. Painful hepatomegaly was significantly relieved in 70% of patients. Transaminases rose as grade 3 toxicity in 15% of patients. Longer overall survival (OS) was significantly observed in patients with performance status 0, child-Pugh A, Barcelona Clinic Liver cancer Stage B, PR and α fetoprotein level decrement. Conclusion: Concurrent chemoradiotherapt provides an acceptable response and palliation of pain in advances HCC. Our findings showed that better survival for patients with good performance and liver functions.

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Comparison of Outcome of Hepatic Arterial Infusion Chemotherapy Combined with Radiotherapy and Sorafenib for Advanced Hepatocellular Carcinoma Patients with Major Portal Vein Tumor Thrombosis

Cited by 41 publications

References 28 publications

Liver resection versus transcatheter arterial chemoembolization for the treatment of patients with hepatocellular carcinoma and hepatic vein or inferior vena cava tumor thrombus: A propensity score matching analysis

Liver resection versus transcatheter arterial chemoembolization for the treatment of patients with hepatocellular carcinoma and hepatic vein or inferior vena cava tumor thrombus: A propensity score matching analysis

Clinical Impact of Hypofractionated Carbon Ion Radiotherapy on Locally Advanced Hepatocellular Carcinoma

Concomitant Chemoradiation Using Gemcitabine in Locally Advanced Hepatocellular Carcinoma

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