Management of Hepatocellular Carcinoma Patients with Portal Vein Thrombosis Using Three-Dimensional Conformal Radiotherapy

Objective: To determine the possible therapeutic gain of using three-dimensional conformal radiotherapy (3D-CRT) as a treatment option for portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma (HCC) and to evaluate the tolerance and toxicity of using such treatment. Materials and methods: Sixty two patients were enrolled in this prospective study between June 2013 and August 2015. The clinical target volume (CTV) was the PVTT and the prescribed dose was 50 Gy/25 fractions. The median follow-up time was 7.4 months. Results: The thrombus crude response rate was 40.4% and the only significant prognostic factor for response was the thrombus size. Responders had significant better survival compared to non-responders with a median survival of 12.5 and 8 months respectively (P Conclusions: The results of this study suggest that radiotherapy should be considered as a safe treatment option for HCC patients with PVTT. It is effective not only for PVTT local control but also for survival, although prospective randomized trials are needed to confirm these results.

肝癌门静脉癌栓的分次立体定向三维适形放射治疗

目的 初步探讨分次立体定向三维适形放射治疗肝癌伴门静脉癌栓患者的近期疗效。方法 3 1例肝癌伴门静脉癌栓患者应用中科院大恒公司适形系列及 3D治疗计划系统。 10MV -X射线总剂量DT40～ 48GY ,1～ 2个中心 ,70 %～ 90 %等剂量曲线包绕肿瘤边缘。分割方式 :68GY 次 ,3次 周。结果 临床症状改善为 10 0 % ;影像学有效率为 85 .7% ;总生物剂量相同时 ,6GY和 8GY组疗效无差别 ;18例门静脉癌栓全消 ,7例大部分消退 ,3例癌栓略缩小 ,所有患者临床症状得以改善 ,生存期延长。结论 分次立体定向三维适形放射治疗肝癌伴门静脉癌栓患者近期疗效肯定 。