Abstract
Hepatocellular carcinoma (HCC) patients with main portal vein tumor thrombus have a median survival time of only about 4 months. We therefore compared the safety and efficacy of endovascular brachytherapy (EVBT) and sequential three-dimensional conformal radiotherapy (3-DCRT). From a cohort of 176 patients, we treated 123 with EVBT using iodine-125 seed strands (group A) and the remaining 53 with sequential 3-DCRT (group B). Overall survival, progression free survival and stent patency characteristics were compared between the two groups. Our analysis demonstrated a median survival of 11.7 ± 1.2 months in group A versus 9.5 ± 1.8 months in group B (p = 0.002). The median progression free survival was 5.3 ± 0.7 months in groupA versus 4.4 ± 0.4 months in group B (p = 0.010). The median stent patency period was 10.3 ± 1.1 months in group A versus 8.7 ± 0.7 months in group B (p = 0.003). Therefore, as compared to sequential 3-DCRT, EVBT combined with portal vein stenting and TACE improved overall survival of HCC patients with main portal vein tumor thrombus.
Highlights
Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide [1]
As compared to sequential 3-DCRT, endovascular brachytherapy (EVBT) combined with portal vein stenting and Trans-arterial chemoembolization (TACE) improved overall survival of HCC patients with main portal vein tumor thrombus
The survival of patients with HCC has improved during recent decades [1], the prognosis of HCC that is complicated by Main portal vein tumor thrombus (MPVTT) remains extremely poor [4]
Summary
Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide [1]. Main portal vein tumor thrombus (MPVTT) increases the metastasis risk, aggravates portal hypertension, and decreases the hepatopedal portal blood flow of the patients [3]. Sorafenib demonstrated survival benefits in recent phase III clinical trials and was considered for standard therapy in advanced HCC patients [5, 6]. External beam radiation therapy [8, 9] and trans-arterial radioembolization with yttrium-90 microspheres [9] treats HCC with portal vein thrombosis. The blood flow of obstructed MPV could not be restored promptly with either external or internal radiotherapy alone. Trans-arterial chemoembolization (TACE) with or without portal vein stenting can be performed safely in advanced HCC with MPV obstruction [10, 11]. The efficacy of TACE for tumor www.impactjournals.com/oncotarget
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
