Adaptation of lenvatinib treatment in patients with hepatocellular carcinoma and portal vein tumor thrombosis

The purpose of the study was to analyze the clinical effect of stereotactic radiosurgery (SRS) (Cyberknife) on hepatocellular carcinoma with portal vein tumor thrombosis (HCC-PVTT). Data from 50 patients with HCC-PVTT who received Cyberknife from August 2013 to April 2016 was collected for efficacy analysis. Moreover, survival correlation was evaluated by Cox proportionalhazards model. The total effective rate in 1â€“3 months after treatment was 64.00%, including 7 cases in complete remission, 12 cases in partial remission, 13 cases in stable conditions, and 18 cases with enlargement; a 4â€“24-months follow-up (with an average of 11.58 Â± 2.58 months) showed that median survival, 1-year cumulative survival rate, and 2-year cumulative survival rate were, respectively, 11.86 Â± 1.79 months, 48.00%, and 20.00%. Moreover, the Cox proportional-hazards model indicates that it was with no correlation between lesion diameter, classification of liver function, pre-operative alphafetoprotein,Â types of hepatitis, number of tumors, ascites, types of tumor emboli, total dose, and survival rate. SRS is effective for HCC-PVTT and serves as an ideal treatment clinically to help preserve patientsâ€™ lives, which is worthy of clinical promotion and application.

Download Full-text

Clinical impact of combined transarterial chemoembolization and radiotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis: An external validation study

Radiotherapy and Oncology ◽

10.1016/j.radonc.2015.11.019 ◽

2016 ◽

Vol 118 (2) ◽

pp. 408-415 ◽

Cited By ~ 17

Author(s):

Jeong Il Yu ◽

Jae Won Park ◽

Hee Chul Park ◽

Sang Min Yoon ◽

Do Hoon Lim ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Portal Vein ◽

Validation Study ◽

Transarterial Chemoembolization ◽

External Validation ◽

Clinical Impact ◽

Advanced Hepatocellular Carcinoma ◽

Portal Vein Tumor Thrombosis ◽

Tumor Thrombosis ◽

External Validation Study

Download Full-text

Liver transplantation for hepatocellular carcinoma with portal vein tumor thrombosis

Journal of Liver Cancer ◽

10.17998/jlc.2021.03.17 ◽

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.

Download Full-text