Abstract
Background
Portal vein tumor thrombosis (PVTT) and inferior vena cava tumor thrombosis (IVCTT) in hepatocellular carcinoma (HCC) are oncological emergent conditions. However, there have been no effective treatments for unresectable HCC with PVTT and/or IVCTT.
Methods
Eleven HCC patients with IVCTT (n=5) and PVTT (n=6), who underwent radiation therapy (RT) for the thrombi as a palliative therapy, were reviewed. All of the patients had no indications for resection, local therapies and TACE. The total radiation dose was 39-60 Gy (median, 50 Gy). The response rate and time to progression of the thrombi, overall survival and the toxicity were analyzed.
Results
Of the 5 patients with IVCTT, the tumor thrombus completely disappeared in 1 patient, 2 patients had a partial response, and 2 patients had stable disease. Of the 6 patients with PVTT, 1 patient had a partial response, 2 patients had stable disease, and 2 patients had progressive disease. The response rate was 60% and 16.7% in IVCTT and PVTT patients respectively. The median survival was 401 days in IVCTT patients and 374 days in PVTT patients. A patient with IVCTT suffered from grade 2 pneumonitis, successfully treated with antibiotics.
Conclusion
RT can be a treatment of choice for IVCTT in unresectable HCC patients, but the effects were limited for PVTT.
