scholarly journals Diffuse Infiltrative Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Completely Cured by Transcatheter Arterial Chemoembolization: Case Report with 8-Year Follow-Up

2016 ◽  
Vol 10 (3) ◽  
pp. 623-628 ◽  
Author(s):  
Suk Bae Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Transcatheter Arterial Chemoembolization ◽  
Treatment Options ◽  
Common Type ◽  
Portal Vein Tumor Thrombosis ◽  
Diffuse Type ◽  
Tumor Thrombosis ◽  
Arterial Chemoembolization

Hepatocellular carcinoma (HCC) is the most common type of liver cancer and its treatment options are determined by shape, liver function, loci, and stages of cancer. Diffuse type of infiltrative HCC accompanied by portal vein tumor thrombosis (PVTT) has the poorest prognosis among other HCCs and there are no other prominent treatment options than systemic chemotherapy. In this study, we report a case of a 56-year-old man with diffuse infiltrative HCC accompanied by PVTT who achieved complete remission for 8 years after receiving conventional transcatheter arterial chemoembolization using adriamycin and gelfoam.

scholarly journals Safety and efficacy of endovascular implantation of a portal vein stent combined with iodine-125 seed-strips followed by transcatheter arterial chemoembolization with sorafenib for the treatment of hepatocellular carcinoma with portal vein tumor thrombosis

2020 ◽  
Vol 93 (1112) ◽  
pp. 20190279
Author(s):  
Shuangxi Li ◽  
Lei Li ◽  
Baohua Li ◽  
Wenhui Wang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Portal Vein ◽  
Transcatheter Arterial Chemoembolization ◽  
Portal Vein Tumor Thrombosis ◽  
Technical Success ◽  
Safety And Efficacy ◽  
Tumor Thrombosis ◽  
Baseline Values ◽  
Arterial Chemoembolization

Objective: To assess the safety and efficacy of endovascular implantation of a portal vein stent combined with iodine-125 seed-strips followed by transcatheter arterial chemoembolization with sorafenib (PVS-125I-TACE-S) for the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Methods: Between January 2015 and July 2017, 18 patients with PVTT caused by HCC that were treated with PVS-125I-TACE-S were reviewed. The technical success, complications, changes in liver function from baseline values due to subsequent endovascular implantation of a portal vein stent combined with iodine-125 seed-strips (PVS-125I), time-to-tumor progression (TTP) and overall survival (OS) were observed. Results: The technical success rate was 100%. Adverse events (AEs) were managed successfully, with no occurrence of procedure-related deaths. Liver function test values after PVS-125I were not significantly different than baseline values (P＞0.05). The median TTP was 7.0 months (range: 4.2–9.9 months). In Vp3 PVTT, the TTP was 9.7 months (range: 8.8–10.5 months), and in Vp4 PVTT, the TTP was 4.2 months (range: 2.8–5.6 months). The median OS was 10.0 months (range: 7.0–13.1 months). In Vp3 PVTT, OS was 11.9 months (range: 9.2–14.5 months), and in Vp4 PVTT, OS was 7.2 months (range: 3.8–10.7 months). Conclusions: PVS-125I-TACE-S is safe for patients with HCC with PVTT and may extend the TTP and survival of patients with Vp4 PVTT. Advances in knowledge: PVS implantation promptly restored flow in the obstructed portal vein, which can reduce the risk of hepatic failure and upper gastrointestinal bleeding. Implantation of iodine-125 seed-strips may directly expose the portal tumor thrombus to radiation and kill cancer cells. Their combined use with TACE-S has a strong scientific rationale.

Stereotactic-body radiotherapy for portal vein tumor thrombosis in hepatocellular carcinoma patients.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 442-442
Author(s):  
Bae Kwon Jeong ◽  
Hoon Sik Choi ◽  
Ki Mun Kang ◽  
Hojin Jeong ◽  
Yun Hee Lee ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Stereotactic Body Radiotherapy ◽  
Treatment Options ◽  
Optimal Dose ◽  
Portal Vein Tumor Thrombosis ◽  
Hepatic Toxicity ◽  
Effective Treatment Option ◽  
Tumor Thrombosis ◽  
Grade 3

442 Background: Portal vein tumor thrombosis (PVTT) is commonly accompanied by hepatocellular carcinoma (HCC) patients, and in these cases the treatment options became limited and treatment outcome was poor. Stereotactic body radiotherapy (SBRT) is one of the possible treatment options, which can deliver higher doses with highly conformal target have conducted for treatment of PVTT. However, only few studies about the SBRT have reported, even treatment schedules were not consistent. In this study, we report our institutional experience of treating PVTT in HCC patients using SBRT. Methods: 24 HCC patients with PVTT were treated with SBRT at our institution. All patients had unresectable HCC with PVTT, baseline liver function of Child-Pugh class A or B. SBRT was performed by Cyberknife based on 4D-simulation and 4D-planning. The prescription dose was 45 Gy in 3 fractions in 17 (70.8%) patients, and was modified to 39 to 42 Gy in 3 to 4 fractions in 7 (29.2%) patients whose target was large or adjacent to the bowel. After SBRT, transarterial chemoembolization (TACE) was performed in 16 (66.7%) patients within 3 months. Results: There were 2 (8.3%) patients of PVTT showed complete response, and 11 (45.8%) patients showed partial response. Stable disease was found in 7 (29.2%) patients, and progression in 4 (16.7%) patients. The response rate was lower in patients with tumor thrombus at main portal vein than those at branch of portal vein (main, 30% vs. branch, 71.4%, p = 0.052). The 1- and 2-year overall survival (OS) was 67.5%, 48.2%, respectively, with median survival of 20.8 months. The combination SBRT followed by TACE, and presence of grade 3 hepatic toxicities impacted on survival. The 1-year OS was 71.4% in patients whom TACE was combined after SBRT, which was higher than that of 14.6% who were treated with SBRT alone (p < 0.001). The 1-year OS was 81.1% in patients who did not occur grade 3 hepatic toxicity, while 0% in patients who had grade 3 hepatic toxicity (p = 0.002). Conclusions: SBRT is a relatively effective treatment option for HCC patients of PVTT. Especially combined with TACE. Finding an optimal dose schedule which can reduce hepatic toxicity, while keeping the response seems important to increase the survival.

scholarly journals Sorafenib Versus Apatinib Both Combined Transarterial Chemoembolization for Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis: A Comparative Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Yanyan Cao ◽  
Tao Sun ◽  
Xiaopeng Guo ◽  
Tao Ouyang ◽  
Xuefeng Kan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Adverse Events ◽  
Portal Vein ◽  
Transarterial Chemoembolization ◽  
Tumor Response ◽  
Portal Vein Tumor Thrombosis ◽  
Time To Progression ◽  
Tumor Thrombosis ◽  
Tace Group

ObjectiveTo compare the efficacy and safety of transarterial chemoembolization (TACE) combining with sorafenib or apatinib for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT).MethodsFrom June 2015 to March 2020, a total of 89 consecutive advanced HCC patients with PVTT who were treated with sorafenib-TACE (S-TACE) or apatinib-TACE (A-TACE) in our center were enrolled. The overall survival (OS), time to progression (TTP), tumor response, and adverse events in the two groups were compared.ResultsThere were 32 and 41 patients included in the S-TACE group and A-TACE group, respectively. The median follow-up was 10.0 months (range, 3.0–36.0 months) in the whole study. The median OS (11.0 vs. 10.0 months, P = 0.419), median TTP (5.0 vs. 6.0 months, P = 0.073), and tumor response (P = 0.529) between the S-TACE group and the A-TACE group were not significantly different. The adverse events related to sorafenib or apatinib were tolerable.ConclusionS-TACE and A-TACE exhibited comparable prognosis for HCC patients with PVTT, which provide another effective and safe method of A-TACE for these patients except for conventional S-TACE.

scholarly journals Evaluation of doxorubicin-eluting bead transcatheter arterial chemoembolization combined with endovascular brachytherapy for hepatocellular carcinoma with main portal vein tumor thrombus

2020 ◽  
Author(s):  
Zhiyuan Wu ◽  
Ju Gong ◽  
Wei Huang ◽  
Qingbing Wang ◽  
Ziyin Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Portal Vein ◽  
Tumor Thrombus ◽  
Transcatheter Arterial Chemoembolization ◽  
Main Portal Vein ◽  
Tace Group ◽  
Iodine 125 ◽  
Arterial Chemoembolization

Abstract Background The goal of this study was to compare the clinical results of conventional transcatheter arterial chemoembolization (C-TACE) and doxorubicin-eluting bead transcatheter arterial chemoembolization (D-TACE) combined with endovascular stent implantation with an iodine-125 seed strand in hepatocellular carcinoma (HCC) patients with main portal vein tumor thrombus (MPVTT).Methods This study was a prospective controlled study with follow-up dates spanning from Mar 2015 to Feb 2020. Patients with both HCC and MPVTT were randomly divided into two groups. Portal vein stents with iodine-125 seed strands were implanted first; then, C-TACE or D-TACE was administered to all patients. Objective response rates were assessed. The time to disease progression and survival rate were compared between the two groups.Results A total of 26 patients were enrolled, with 13 in each group. During follow-up, the portal stent patency times were 112.3±98.2 days in the C-TACE group and 101.7±90.4 days in the D-TACE group. The time to disease progression was 42 days in the C-TACE group and 120 days in the D-TACE group (p=0.03). The overall survival time from the first intervention procedure was 216 days in the C-TACE group and 239 days in the D-TACE group (p=0.047). The D-TACE group was superior to the C-TACE group in terms of progression-free survival (PFS) and overall survival (OS) times.Conclusion Endovascular implantation of a stent with an iodine-125 seed strand combined with TACE is safe and effective in HCC patients with MPVTT. Compared to C-TACE, D-TACE achieves more benefits regarding PFS and OS.Trial registration This study was a cohort study, no health-related interventions to evaluate the effects on health outcomes. This study wasn’t a clinical trial.

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