Abstract
BackgroundHepatocellular carcinoma (HCC) with a tumor thrombus in the inferior vena cava (IVC) and right atrium (RA) rarely occurs and is usually associated with extremely poor prognosis, we carried out this study to evaluate the efficacy and safety of a combination of trans-arterial chemoembolization (TACE) and external beam radiation therapy (EBRT) in the treatment of HCC with a tumor thrombus in the IVC and RA.MethodsFrom September 2005 to September 2008, 11 cases of HCC with a tumor thrombus in the IVC and RA were treated with a combination of TACE and EBRT. Clinical adverse events, laboratory toxicity, and survival were retrospectively studied.ResultsThirty-one interventional procedures were conducted and EBRT was performed 11 times. All treatments were successful and without significant complications. No severe adverse effects were observed. The median survival time of the 11 cases was 21.0 months. One patient was monitored for 97 months and no recurrence was observed.ConclusionThe combination of TACE and EBRT can be safely performed and may improve the prognosis of the HCC cases with a tumor thrombus in the IVC and RA.
Highlights
Hepatocellular carcinoma (HCC) with a tumor thrombus in the inferior vena cava (IVC) and right atrium (RA) rarely occurs and is usually associated with extremely poor prognosis, we carried out this study to evaluate the efficacy and safety of a combination of trans-arterial chemoembolization (TACE) and external beam radiation therapy (EBRT) in the treatment of HCC with a tumor thrombus in the IVC and RA
HCC that has invaded into the IVC and RA is usually treated with surgery, radiotherapy (RT), trans-arterial chemoembolization (TACE), and chemotherapy
Patients and treatment protocol Between September 2005 and September 2008, a total of 11 patients who were diagnosed with advanced HCC with IVC and RA tumor thrombus were treated by a combination of TACE and EBRT
Summary
Hepatocellular carcinoma (HCC) with a tumor thrombus in the inferior vena cava (IVC) and right atrium (RA) rarely occurs and is usually associated with extremely poor prognosis, we carried out this study to evaluate the efficacy and safety of a combination of trans-arterial chemoembolization (TACE) and external beam radiation therapy (EBRT) in the treatment of HCC with a tumor thrombus in the IVC and RA. HCC with an extension to the inferior vena cava (IVC) and right atrium (RA) rarely occurs and is usually associated with extremely poor prognosis. HCC that has invaded into the IVC and RA is usually treated with surgery, radiotherapy (RT), trans-arterial chemoembolization (TACE), and chemotherapy. TACE is a relatively safe treatment procedure, its therapeutic effect, especially for tumor thrombi in IVCs and RAs, remains unsatisfactory [5, 6]
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