Author(s)

Ahmed Abo Gabal^1*, Mohamed Lotayef¹, Hoda Abd Elbaky¹, Maha Hassan¹, Heba Elzawahry², Ekram Hamed³

¹Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.
²Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.
³Department of Radio-Diagnosis, National Cancer Institute, Cairo University, Cairo, Egypt.

Objective: To determine the possible therapeutic gain of using three-dimensional conformal radiotherapy (3D-CRT) as a treatment option for portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma (HCC) and to evaluate the tolerance and toxicity of using such treatment. Materials and methods: Sixty two patients were enrolled in this prospective study between June 2013 and August 2015. The clinical target volume (CTV) was the PVTT and the prescribed dose was 50 Gy/25 fractions. The median follow-up time was 7.4 months. Results: The thrombus crude response rate was 40.4% and the only significant prognostic factor for response was the thrombus size. Responders had significant better survival compared to non-responders with a median survival of 12.5 and 8 months respectively (P < 0.0001). The radiation toxicity profile was satisfactory. Conclusions: The results of this study suggest that radiotherapy should be considered as a safe treatment option for HCC patients with PVTT. It is effective not only for PVTT local control but also for survival, although prospective randomized trials are needed to confirm these results.

Hepatocellular Carcinoma, Portal Vein Thrombosis, 3D Conformal Radiotherapy, Portal Vein Tumor Thrombus

Gabal, A. , Lotayef, M. , Elbaky, H. , Hassan, M. , Elzawahry, H. and Hamed, E. (2017) Management of Hepatocellular Carcinoma Patients with Portal Vein Thrombosis Using Three-Dimensional Conformal Radiotherapy. Journal of Cancer Therapy, 8, 579-590. doi: 10.4236/jct.2017.86049.