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Efficacy of three-dimensional conformal radiotherapy combined with transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus

Authors Wu F, Lu H, Zhu S, Li Z, Zou L, Bai T, Chen J, Yang T, Liang S

Received 19 May 2016

Accepted for publication 30 July 2016

Published 1 December 2016 Volume 2016:9 Pages 7141—7147

DOI https://doi.org/10.2147/OTT.S113161

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Ram Prasad

Peer reviewer comments 2

Editor who approved publication: Dr William Cho


Fei-Xiang Wu,1–3,* Hui-Rong Lu,4,* Shao-Liang Zhu,1,* Zi-Hui Li,1 Ling Zou,1 Tao Bai,1 Jie Chen,1 Tian-Bo Yang,1 Shi-Xiong Liang4,5

1Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 2Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 3Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Ministry of Education, Shanghai, 4Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 5Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Objective: The current study aimed to evaluate the efficacy and outcomes of three-dimensional conformal radiotherapy (3DCRT) combined with transarterial chemoembolization (TACE) for treating patients with hepatocellular carcinoma involving portal vein tumor thrombus.
Methods: During 2000 and 2013, a total of 182 hepatocellular carcinoma patients with portal vein tumor thrombus were retrospectively analyzed: 68 patients were treated by 3DCRT alone (group A), 74 by TACE alone (group B), and 40 by a combination of 3DCRT + TACE (group C). The overall survival (OS) of the three groups was compared using the Kaplan–Meier method. The independent predictors of survival were identified using multivariate analysis.
Results: The total effective rate (complete response + partial response) among all patients was 44% (80/182). The objective response rate (complete response + partial response) was higher in group C than in group A or B, but the differences were not significant. OS rates at 1, 2, and 3 years were significantly higher in group C than in group A or B (P<0.05), while OS rates were similar between groups A and B. Multivariate analysis identified serum levels of alpha-fetoprotein <400 ng/mL and the use of 3DCRT + TACE as independent predictors of better OS.
Conclusion: These results suggest that combining 3DCRT with TACE may provide better OS than either technique alone in hepatocellular carcinoma patients with portal vein tumor thrombus.

Keywords: hepatocellular carcinoma, portal vein tumor thrombus, three-dimensional conformal radiotherapy, transarterial chemoembolization, overall survival

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