Radiotherapy for inferior vena cava tumor thrombus in patients with hepatocellular carcinoma

Research output: Contribution to journalArticle

Abstract

Background: Hepatocellular carcinoma (HCC) with inferior vena cava (IVC) involvement is a rare disease with poor prognosis. This study aimed to evaluate the outcome of HCC patients receiving radiotherapy (RT) to IVC tumor thrombus. Methods: A total of 42 consecutive HCC patients treated with RT to IVC tumor thrombus between September 2007 and October 2018 were enrolled. Overall survival (OS), the response of IVC thrombus, prognostic factors and failure pattern were assessed. Results: The median follow-up time was 4.4 months. The median RT equivalent dose in 2-Gy fractions was 48.75 Gy (range, 3.25-67.10). The objective response rate of IVC thrombus was 47.6% (95% confidence interval [CI], 33.3-64.3%). The OS rate at 1 year was 30.0%, with a median OS of 6.6 months (95% CI, 3.7-9.5) from the start of RT. On multivariate analysis, Child-Pugh class, lymph node metastasis, lung metastasis and objective response of IVC thrombus were independent predictors for OS. Lung was the most common site of first progression in 14 (33.3%) patients. For 32 patients without lung metastasis before RT, use of systemic treatment concurrent with and/or after RT was associated with a significantly longer lung metastasis-free survival (5.9 vs. 1.5 months, p = 0.0033). Conclusions: RT is effective for IVC tumor thrombus of HCC with acceptable adverse effects. RT might be a treatment option incorporated into combination therapy for HCC involving IVC.

Original languageEnglish
Article number560
JournalBMC cancer
Volume19
Issue number1
DOIs
Publication statusPublished - 2019 Jun 10

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Inferior Vena Cava
Hepatocellular Carcinoma
Thrombosis
Radiotherapy
Neoplasms
Neoplasm Metastasis
Lung
Survival
Confidence Intervals
Rare Diseases
Therapeutics
Multivariate Analysis
Survival Rate
Lymph Nodes

All Science Journal Classification (ASJC) codes

  • Genetics
  • Oncology
  • Cancer Research

Cite this

@article{e6301a5f5071401889e3387bee2d401e,
title = "Radiotherapy for inferior vena cava tumor thrombus in patients with hepatocellular carcinoma",
abstract = "Background: Hepatocellular carcinoma (HCC) with inferior vena cava (IVC) involvement is a rare disease with poor prognosis. This study aimed to evaluate the outcome of HCC patients receiving radiotherapy (RT) to IVC tumor thrombus. Methods: A total of 42 consecutive HCC patients treated with RT to IVC tumor thrombus between September 2007 and October 2018 were enrolled. Overall survival (OS), the response of IVC thrombus, prognostic factors and failure pattern were assessed. Results: The median follow-up time was 4.4 months. The median RT equivalent dose in 2-Gy fractions was 48.75 Gy (range, 3.25-67.10). The objective response rate of IVC thrombus was 47.6{\%} (95{\%} confidence interval [CI], 33.3-64.3{\%}). The OS rate at 1 year was 30.0{\%}, with a median OS of 6.6 months (95{\%} CI, 3.7-9.5) from the start of RT. On multivariate analysis, Child-Pugh class, lymph node metastasis, lung metastasis and objective response of IVC thrombus were independent predictors for OS. Lung was the most common site of first progression in 14 (33.3{\%}) patients. For 32 patients without lung metastasis before RT, use of systemic treatment concurrent with and/or after RT was associated with a significantly longer lung metastasis-free survival (5.9 vs. 1.5 months, p = 0.0033). Conclusions: RT is effective for IVC tumor thrombus of HCC with acceptable adverse effects. RT might be a treatment option incorporated into combination therapy for HCC involving IVC.",
author = "Pao, {Tzu Hui} and Wei-Ting Hsueh and Wei-Lun Chang and Chiang, {Nai Jung} and Yih-Jyh Lin and Yi-Sheng Liu and Forn-Chia Lin",
year = "2019",
month = "6",
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doi = "10.1186/s12885-019-5654-9",
language = "English",
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Radiotherapy for inferior vena cava tumor thrombus in patients with hepatocellular carcinoma. / Pao, Tzu Hui; Hsueh, Wei-Ting; Chang, Wei-Lun; Chiang, Nai Jung; Lin, Yih-Jyh; Liu, Yi-Sheng; Lin, Forn-Chia.

In: BMC cancer, Vol. 19, No. 1, 560, 10.06.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Radiotherapy for inferior vena cava tumor thrombus in patients with hepatocellular carcinoma

AU - Pao, Tzu Hui

AU - Hsueh, Wei-Ting

AU - Chang, Wei-Lun

AU - Chiang, Nai Jung

AU - Lin, Yih-Jyh

AU - Liu, Yi-Sheng

AU - Lin, Forn-Chia

PY - 2019/6/10

Y1 - 2019/6/10

N2 - Background: Hepatocellular carcinoma (HCC) with inferior vena cava (IVC) involvement is a rare disease with poor prognosis. This study aimed to evaluate the outcome of HCC patients receiving radiotherapy (RT) to IVC tumor thrombus. Methods: A total of 42 consecutive HCC patients treated with RT to IVC tumor thrombus between September 2007 and October 2018 were enrolled. Overall survival (OS), the response of IVC thrombus, prognostic factors and failure pattern were assessed. Results: The median follow-up time was 4.4 months. The median RT equivalent dose in 2-Gy fractions was 48.75 Gy (range, 3.25-67.10). The objective response rate of IVC thrombus was 47.6% (95% confidence interval [CI], 33.3-64.3%). The OS rate at 1 year was 30.0%, with a median OS of 6.6 months (95% CI, 3.7-9.5) from the start of RT. On multivariate analysis, Child-Pugh class, lymph node metastasis, lung metastasis and objective response of IVC thrombus were independent predictors for OS. Lung was the most common site of first progression in 14 (33.3%) patients. For 32 patients without lung metastasis before RT, use of systemic treatment concurrent with and/or after RT was associated with a significantly longer lung metastasis-free survival (5.9 vs. 1.5 months, p = 0.0033). Conclusions: RT is effective for IVC tumor thrombus of HCC with acceptable adverse effects. RT might be a treatment option incorporated into combination therapy for HCC involving IVC.

AB - Background: Hepatocellular carcinoma (HCC) with inferior vena cava (IVC) involvement is a rare disease with poor prognosis. This study aimed to evaluate the outcome of HCC patients receiving radiotherapy (RT) to IVC tumor thrombus. Methods: A total of 42 consecutive HCC patients treated with RT to IVC tumor thrombus between September 2007 and October 2018 were enrolled. Overall survival (OS), the response of IVC thrombus, prognostic factors and failure pattern were assessed. Results: The median follow-up time was 4.4 months. The median RT equivalent dose in 2-Gy fractions was 48.75 Gy (range, 3.25-67.10). The objective response rate of IVC thrombus was 47.6% (95% confidence interval [CI], 33.3-64.3%). The OS rate at 1 year was 30.0%, with a median OS of 6.6 months (95% CI, 3.7-9.5) from the start of RT. On multivariate analysis, Child-Pugh class, lymph node metastasis, lung metastasis and objective response of IVC thrombus were independent predictors for OS. Lung was the most common site of first progression in 14 (33.3%) patients. For 32 patients without lung metastasis before RT, use of systemic treatment concurrent with and/or after RT was associated with a significantly longer lung metastasis-free survival (5.9 vs. 1.5 months, p = 0.0033). Conclusions: RT is effective for IVC tumor thrombus of HCC with acceptable adverse effects. RT might be a treatment option incorporated into combination therapy for HCC involving IVC.

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U2 - 10.1186/s12885-019-5654-9

DO - 10.1186/s12885-019-5654-9

M3 - Article

C2 - 31182065

AN - SCOPUS:85067113577

VL - 19

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

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