Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study

Takuya Nagano; Akihiko Hoshi; Masayuki Kurosaki; Kazuma Sasamura; Kaoru Tsuchiya; Kazuma Toda; Hirofumi Kuwabara; Meika Namba; Daigoro Matsubara; Sayako Oota; Yasuo Yoshioka; Ryoichi Yoshimura; Namiki Izumi

doi:doi:10.11648/j.ijcocr.20200503.13

Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study

Takuya Nagano, Akihiko Hoshi, Masayuki Kurosaki, Kazuma Sasamura, Kaoru Tsuchiya, Kazuma Toda, Hirofumi Kuwabara, Meika Namba, Daigoro Matsubara, Sayako Oota, Yasuo Yoshioka, Ryoichi Yoshimura, Namiki Izumi

Published in International Journal of Clinical Oncology and Cancer Research (Volume 5, Issue 3)

Received: 16 September 2020 Accepted: 27 September 2020 Published: 7 October 2020

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Abstract

Background: The aim of this multicenter study was to evaluate the outcome of radiotherapy (RT) that targeted for tumor thrombi (TT) from hepatocellular carcinoma (HCC), including the portal vein, hepatic vein, inferior vena cava, and bile duct TT. Methods: Patients who received RT for the treatment of TT between 2005 and 2020 were retrospectively reviewed. We compared patient characteristics, overall survival (OS), the combined chemotherapy regimen, and objective response rates (ORRs) between the treatment modalities and analyzed cumulative incidence formula (CIF) for the deterioration in the Child-Pugh class and the progression of intrahepatic tumors. Results: We evaluated 64 patients, 39 of whom received combined chemotherapy with RT. Multivariate analysis showed that the Child-Pugh class, primary tumor size and the response of TT were significant prognostic factors for OS and the total equivalent dose in 2 Gy fractions (EQD2) of more than 48.75 Gy significantly contributed to ORRs (p=0.04). In the multivariate analysis of CIF, only acute liver damage was the significant factor for the deterioration in the Child-Pugh class (p=0.01) and the length of TT was significant for the progression of intrahepatic tumors (p=0.03). Conclusion: High doses should be delivered to TT, but long tumor thrombi are difficult to control. Tumor thrombus length is more important in predicting intrahepatic progression than the location of the tumor thrombus.

Published in	International Journal of Clinical Oncology and Cancer Research (Volume 5, Issue 3)
DOI	10.11648/j.ijcocr.20200503.13
Page(s)	65-77
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Combined Chemotherapy, Radiation Therapy, Hepatocellular Carcinoma, Macroscopic Vascular Invasion, Tumor Thrombosis

References

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APA Style

Takuya Nagano, Akihiko Hoshi, Masayuki Kurosaki, Kazuma Sasamura, Kaoru Tsuchiya, et al. (2020). Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study. International Journal of Clinical Oncology and Cancer Research, 5(3), 65-77. https://doi.org/10.11648/j.ijcocr.20200503.13

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ACS Style

Takuya Nagano; Akihiko Hoshi; Masayuki Kurosaki; Kazuma Sasamura; Kaoru Tsuchiya, et al. Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study. Int. J. Clin. Oncol. Cancer Res. 2020, 5(3), 65-77. doi: 10.11648/j.ijcocr.20200503.13

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AMA Style

Takuya Nagano, Akihiko Hoshi, Masayuki Kurosaki, Kazuma Sasamura, Kaoru Tsuchiya, et al. Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study. Int J Clin Oncol Cancer Res. 2020;5(3):65-77. doi: 10.11648/j.ijcocr.20200503.13

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@article{10.11648/j.ijcocr.20200503.13,
  author = {Takuya Nagano and Akihiko Hoshi and Masayuki Kurosaki and Kazuma Sasamura and Kaoru Tsuchiya and Kazuma Toda and Hirofumi Kuwabara and Meika Namba and Daigoro Matsubara and Sayako Oota and Yasuo Yoshioka and Ryoichi Yoshimura and Namiki Izumi},
  title = {Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {5},
  number = {3},
  pages = {65-77},
  doi = {10.11648/j.ijcocr.20200503.13},
  url = {https://doi.org/10.11648/j.ijcocr.20200503.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20200503.13},
  abstract = {Background: The aim of this multicenter study was to evaluate the outcome of radiotherapy (RT) that targeted for tumor thrombi (TT) from hepatocellular carcinoma (HCC), including the portal vein, hepatic vein, inferior vena cava, and bile duct TT. Methods: Patients who received RT for the treatment of TT between 2005 and 2020 were retrospectively reviewed. We compared patient characteristics, overall survival (OS), the combined chemotherapy regimen, and objective response rates (ORRs) between the treatment modalities and analyzed cumulative incidence formula (CIF) for the deterioration in the Child-Pugh class and the progression of intrahepatic tumors. Results: We evaluated 64 patients, 39 of whom received combined chemotherapy with RT. Multivariate analysis showed that the Child-Pugh class, primary tumor size and the response of TT were significant prognostic factors for OS and the total equivalent dose in 2 Gy fractions (EQD2) of more than 48.75 Gy significantly contributed to ORRs (p=0.04). In the multivariate analysis of CIF, only acute liver damage was the significant factor for the deterioration in the Child-Pugh class (p=0.01) and the length of TT was significant for the progression of intrahepatic tumors (p=0.03). Conclusion: High doses should be delivered to TT, but long tumor thrombi are difficult to control. Tumor thrombus length is more important in predicting intrahepatic progression than the location of the tumor thrombus.},
 year = {2020}
}

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TY  - JOUR
T1  - Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study
AU  - Takuya Nagano
AU  - Akihiko Hoshi
AU  - Masayuki Kurosaki
AU  - Kazuma Sasamura
AU  - Kaoru Tsuchiya
AU  - Kazuma Toda
AU  - Hirofumi Kuwabara
AU  - Meika Namba
AU  - Daigoro Matsubara
AU  - Sayako Oota
AU  - Yasuo Yoshioka
AU  - Ryoichi Yoshimura
AU  - Namiki Izumi
Y1  - 2020/10/07
PY  - 2020
N1  - https://doi.org/10.11648/j.ijcocr.20200503.13
DO  - 10.11648/j.ijcocr.20200503.13
T2  - International Journal of Clinical Oncology and Cancer Research
JF  - International Journal of Clinical Oncology and Cancer Research
JO  - International Journal of Clinical Oncology and Cancer Research
SP  - 65
EP  - 77
PB  - Science Publishing Group
SN  - 2578-9511
UR  - https://doi.org/10.11648/j.ijcocr.20200503.13
AB  - Background: The aim of this multicenter study was to evaluate the outcome of radiotherapy (RT) that targeted for tumor thrombi (TT) from hepatocellular carcinoma (HCC), including the portal vein, hepatic vein, inferior vena cava, and bile duct TT. Methods: Patients who received RT for the treatment of TT between 2005 and 2020 were retrospectively reviewed. We compared patient characteristics, overall survival (OS), the combined chemotherapy regimen, and objective response rates (ORRs) between the treatment modalities and analyzed cumulative incidence formula (CIF) for the deterioration in the Child-Pugh class and the progression of intrahepatic tumors. Results: We evaluated 64 patients, 39 of whom received combined chemotherapy with RT. Multivariate analysis showed that the Child-Pugh class, primary tumor size and the response of TT were significant prognostic factors for OS and the total equivalent dose in 2 Gy fractions (EQD2) of more than 48.75 Gy significantly contributed to ORRs (p=0.04). In the multivariate analysis of CIF, only acute liver damage was the significant factor for the deterioration in the Child-Pugh class (p=0.01) and the length of TT was significant for the progression of intrahepatic tumors (p=0.03). Conclusion: High doses should be delivered to TT, but long tumor thrombi are difficult to control. Tumor thrombus length is more important in predicting intrahepatic progression than the location of the tumor thrombus.
VL  - 5
IS  - 3
ER  -

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Author Information

Takuya Nagano

Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
Akihiko Hoshi

Department of Radiology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Masayuki Kurosaki

Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Kazuma Sasamura

Department of Radiation Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
Kaoru Tsuchiya

Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Kazuma Toda

Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
Hirofumi Kuwabara

Department of Radiology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Meika Namba

Department of Radiology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
Daigoro Matsubara

Department of Radiology, Asahi General Hospital, Asahi-shi, Chiba, Japan
Sayako Oota

Department of Radiology, Asahi General Hospital, Asahi-shi, Chiba, Japan
Yasuo Yoshioka

Department of Radiation Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
Ryoichi Yoshimura

Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
Namiki Izumi

Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan

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APA Style

Takuya Nagano, Akihiko Hoshi, Masayuki Kurosaki, Kazuma Sasamura, Kaoru Tsuchiya, et al. (2020). Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study. International Journal of Clinical Oncology and Cancer Research, 5(3), 65-77. https://doi.org/10.11648/j.ijcocr.20200503.13

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ACS Style

Takuya Nagano; Akihiko Hoshi; Masayuki Kurosaki; Kazuma Sasamura; Kaoru Tsuchiya, et al. Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study. Int. J. Clin. Oncol. Cancer Res. 2020, 5(3), 65-77. doi: 10.11648/j.ijcocr.20200503.13

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AMA Style

Takuya Nagano, Akihiko Hoshi, Masayuki Kurosaki, Kazuma Sasamura, Kaoru Tsuchiya, et al. Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study. Int J Clin Oncol Cancer Res. 2020;5(3):65-77. doi: 10.11648/j.ijcocr.20200503.13

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@article{10.11648/j.ijcocr.20200503.13,
  author = {Takuya Nagano and Akihiko Hoshi and Masayuki Kurosaki and Kazuma Sasamura and Kaoru Tsuchiya and Kazuma Toda and Hirofumi Kuwabara and Meika Namba and Daigoro Matsubara and Sayako Oota and Yasuo Yoshioka and Ryoichi Yoshimura and Namiki Izumi},
  title = {Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {5},
  number = {3},
  pages = {65-77},
  doi = {10.11648/j.ijcocr.20200503.13},
  url = {https://doi.org/10.11648/j.ijcocr.20200503.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20200503.13},
  abstract = {Background: The aim of this multicenter study was to evaluate the outcome of radiotherapy (RT) that targeted for tumor thrombi (TT) from hepatocellular carcinoma (HCC), including the portal vein, hepatic vein, inferior vena cava, and bile duct TT. Methods: Patients who received RT for the treatment of TT between 2005 and 2020 were retrospectively reviewed. We compared patient characteristics, overall survival (OS), the combined chemotherapy regimen, and objective response rates (ORRs) between the treatment modalities and analyzed cumulative incidence formula (CIF) for the deterioration in the Child-Pugh class and the progression of intrahepatic tumors. Results: We evaluated 64 patients, 39 of whom received combined chemotherapy with RT. Multivariate analysis showed that the Child-Pugh class, primary tumor size and the response of TT were significant prognostic factors for OS and the total equivalent dose in 2 Gy fractions (EQD2) of more than 48.75 Gy significantly contributed to ORRs (p=0.04). In the multivariate analysis of CIF, only acute liver damage was the significant factor for the deterioration in the Child-Pugh class (p=0.01) and the length of TT was significant for the progression of intrahepatic tumors (p=0.03). Conclusion: High doses should be delivered to TT, but long tumor thrombi are difficult to control. Tumor thrombus length is more important in predicting intrahepatic progression than the location of the tumor thrombus.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Clinical Results of Radiotherapy That Targeted for Tumor Thrombi from Hepatocellular Carcinoma: A Multicenter Retrospective Study
AU  - Takuya Nagano
AU  - Akihiko Hoshi
AU  - Masayuki Kurosaki
AU  - Kazuma Sasamura
AU  - Kaoru Tsuchiya
AU  - Kazuma Toda
AU  - Hirofumi Kuwabara
AU  - Meika Namba
AU  - Daigoro Matsubara
AU  - Sayako Oota
AU  - Yasuo Yoshioka
AU  - Ryoichi Yoshimura
AU  - Namiki Izumi
Y1  - 2020/10/07
PY  - 2020
N1  - https://doi.org/10.11648/j.ijcocr.20200503.13
DO  - 10.11648/j.ijcocr.20200503.13
T2  - International Journal of Clinical Oncology and Cancer Research
JF  - International Journal of Clinical Oncology and Cancer Research
JO  - International Journal of Clinical Oncology and Cancer Research
SP  - 65
EP  - 77
PB  - Science Publishing Group
SN  - 2578-9511
UR  - https://doi.org/10.11648/j.ijcocr.20200503.13
AB  - Background: The aim of this multicenter study was to evaluate the outcome of radiotherapy (RT) that targeted for tumor thrombi (TT) from hepatocellular carcinoma (HCC), including the portal vein, hepatic vein, inferior vena cava, and bile duct TT. Methods: Patients who received RT for the treatment of TT between 2005 and 2020 were retrospectively reviewed. We compared patient characteristics, overall survival (OS), the combined chemotherapy regimen, and objective response rates (ORRs) between the treatment modalities and analyzed cumulative incidence formula (CIF) for the deterioration in the Child-Pugh class and the progression of intrahepatic tumors. Results: We evaluated 64 patients, 39 of whom received combined chemotherapy with RT. Multivariate analysis showed that the Child-Pugh class, primary tumor size and the response of TT were significant prognostic factors for OS and the total equivalent dose in 2 Gy fractions (EQD2) of more than 48.75 Gy significantly contributed to ORRs (p=0.04). In the multivariate analysis of CIF, only acute liver damage was the significant factor for the deterioration in the Child-Pugh class (p=0.01) and the length of TT was significant for the progression of intrahepatic tumors (p=0.03). Conclusion: High doses should be delivered to TT, but long tumor thrombi are difficult to control. Tumor thrombus length is more important in predicting intrahepatic progression than the location of the tumor thrombus.
VL  - 5
IS  - 3
ER  -

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