Effectiveness and safety of proton beam therapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis

2014 ◽  
Vol 190 (9) ◽  
pp. 806-814 ◽  
Author(s):  
Sung Uk Lee ◽  
Joong-Won Park ◽  
Tae Hyun Kim ◽  
Yeon-Joo Kim ◽  
Sang Myung Woo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Advanced Hepatocellular Carcinoma ◽  
Portal Vein Tumor Thrombosis ◽  
Tumor Thrombosis

scholarly journals PO-0704: Proton beam therapy for hepatocellular carcinoma with extensive portal vein tumor thrombosis

2015 ◽  
Vol 115 ◽  
pp. S346
Author(s):  
T. Okumura ◽  
N. Fukumitsu ◽  
M. Mizumoto ◽  
H. Ishikawa ◽  
K. Ohnishi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Portal Vein Tumor Thrombosis ◽  
Tumor Thrombosis

Proton-Beam Therapy for Hepatocellular Carcinoma Associated with Portal Vein Tumor Thrombosis*

2009 ◽  
Vol 185 (12) ◽  
pp. 782-788 ◽  
Author(s):  
Shinji Sugahara ◽  
Hidetsugu Nakayama ◽  
Kuniaki Fukuda ◽  
Masashi Mizumoto ◽  
Mari Tokita ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Portal Vein Tumor Thrombosis ◽  
Tumor Thrombosis

Liver transplantation for hepatocellular carcinoma with portal vein tumor thrombosis

2021 ◽  
Vol 21 (2) ◽  
pp. 105-112
Author(s):  
Sang Jin Kim ◽  
Jong Man Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Radiation Therapy ◽  
Portal Vein ◽  
Alpha Fetoprotein ◽  
Advanced Hepatocellular Carcinoma ◽  
Portal Vein Tumor Thrombosis ◽  
Donor Liver Transplantation ◽  
Tumor Thrombosis ◽  
Locoregional Therapies

Traditionally, liver transplantation for hepatocellular carcinoma with portal vein tumor thrombosis is not recommended. However, with recent developments in locoregional therapies for hepatocellular carcinoma, more aggressive treatments have been attempted for advanced hepatocellular carcinoma. Recently, various studies on locoregional therapies for downstaging followed by living donor liver transplantation reported inspiring overall survival and recurrence-free survival of patients. These downstaging procedures included three-dimensional conformal radiation therapy, trans-arterial chemoembolization, stereotactic body radiation therapy, trans-arterial radioembolization, hepatic arterial infusion chemotherapy and combinations of these therapies. Selection of the optimal downstaging protocol should depend on tumor location, biology and background liver status. The risk factors affecting outcome include pre-downstaging alpha-fetoprotein values, delta alpha-fetoprotein values, disappearance of portal vein tumor thrombosis on imaging and meeting the Milan criteria or not after downstaging. For hepatocellular carcinoma with portal vein tumor thrombosis, downstaging procedure with liver transplantation in mind would be helpful. If the reaction of the downstaged tumor is good, liver transplantation may be performed.

scholarly journals Efficacy of External Beam Radiation-Based Treatment plus Locoregional Therapy for Hepatocellular Carcinoma Associated with Portal Vein Tumor Thrombosis

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Ming-Yang Chen ◽  
Yu-Chao Wang ◽  
Tsung-Han Wu ◽  
Chen-Fang Lee ◽  
Ting-Jung Wu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Surgical Management ◽  
External Beam Radiation ◽  
Locoregional Therapy ◽  
Advanced Hepatocellular Carcinoma ◽  
External Beam ◽  
Portal Vein Tumor Thrombosis ◽  
Beam Radiation ◽  
Tumor Thrombosis

Background. Portal vein tumor thrombosis (PVTT) is a common event in advanced hepatocellular carcinoma (HCC). The optimal treatment for these patients remains controversial. Methods. A retrospective review of 149 patients who had unresectable HCC associated with PVTT between January 2005 and December 2012 was performed. Outcomes related to external beam radiation-based treatment were measured, and clinicopathological features and parameters affecting prognosis were analyzed as well. Results. The radiotherapeutic response of PVTT was an important element that affected the overall treatment response of HCC. Serum α-fetoprotein < 400 ng/mL, the presence of a radiotherapeutic response on PVTT, and receiving additional locoregional therapy were significant prognostic factors affecting the survival of patients. Patients who had received additional locoregional therapy obtained a better outcome, and six of them were eventually able to undergo surgical management with curative intent. Conclusion. The outcome of HCC associated with PVTT remains pessimistic. In addition to the current recommended treatment using sorafenib, a combination of external beam radiotherapy targeting PVTT and locoregional therapy for intrahepatic HCC might be a promising strategy for patients who had unresectable HCC with PVTT. This approach could perhaps offer patients a favorable outcome as well as a possible cure with following surgical management.

scholarly journals Transarterial Chemoembolization for the Treatment of Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: Prognostic Factors in a Single-Center Study of 188 Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Lei Liu ◽  
Cheng Zhang ◽  
Yan Zhao ◽  
Xingshun Qi ◽  
Hui Chen ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Portal Vein ◽  
Transarterial Chemoembolization ◽  
Cox Regression ◽  
Advanced Hepatocellular Carcinoma ◽  
Portal Vein Tumor Thrombosis ◽  
Cox Regression Analysis ◽  
Tumor Thrombosis ◽  
Pugh Class

Transarterial chemoembolization (TACE) could achieve a better survival benefit than conservative treatment for advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). In this retrospective study, all HCC patients with Child-Pugh score <7 and PVTT who were consecutively admitted to our center between January 2006 and June 2012 and underwent TACE were enrolled. The efficacy and safety of TACE were analyzed. Prognostic factors were determined by Cox regression analysis. Of the 188 patients included, 89% had hepatitis B virus infection, 100% were at Barcelona Clinic Liver Cancer stage C, and 81% (n=152) and 19% (n=36) were at Child-Pugh classes A and B, respectively. The incidence of procedure-related complications was 88%. No procedure-related death was found. The median overall survival was 6.1 months. Type of PVTT (hazard ratio [HR] = 2.806), number of tumor lesions (HR = 2.288), Child-Pugh class (HR = 2.981), and presence of metastasis (HR = 1.909) were the independent predictors of survival. In conclusion, TACE could be selectively used for the treatment of advanced HCC with PVTT. But a high rate of postoperative adverse events should not be undermined in spite of no procedure-related death. Preoperative type of PVTT, number of tumor lesions, Child-Pugh class, and metastasis could predict the prognosis of these patients.

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