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Prognostic factors for patients with hepatocellular carcinoma with macroscopic portal vein or inferior vena cava tumor thrombi receiving external-beam radiation therapy
- Source :
- Cancer Science. 99:2510-2517
- Publication Year :
- 2008
- Publisher :
- Wiley, 2008.
-
Abstract
- Prognostic factors in patients with hepatocellular carcinoma (HCC) with tumor thrombosis are not well established, especially for those given external-beam radiation therapy (EBRT). Patients (n = 136) with HCC who had portal vein (PV) or inferior vena cava (IVC) tumor thrombus received EBRT between January 1998 and October 2007. Demographic variables, laboratory values, tumor characteristics, and treatment modalities were determined at diagnosis and before EBRT. The total radiation dose ranged from 30 to 60 Gy (median, 50 Gy) and was focused on the tumor thrombi. Predictors of survival were identified using the univariate and multivariate analysis. Of the 136 patients, the tumor thrombus completely disappeared in 41 patients (30.1%), 36 patients (26.5%) had a partial response, 49 patients (36%) had stable disease, and 10 patients (7.4%) had progressive disease. On multivariate analysis, pretreatment unfavorable predictors were associated with lower albumin, higher gamma-glutamyltransferase and alpha-fetoprotein levels, poorer Child-Pugh classification, intrahepatic multifocality, lymph node metastases, poorer response to EBRT, and 2-dimension EBRT technique. Survival rates at 1, 2, and 3 years were 31.8%, 17.5%, and 8.8% for patients with PV tumor thrombi; 66.3%, 21.1%, and 15.8% for IVC tumor thrombi; and 25%, 8.3%, and 0% for PV plus IVC tumor thrombi, respectively. Overall median survival was 9.7 months. This study provides detailed information about the survival outcomes and prognostic factors of HCC with tumor thrombi in a relatively large cohort of patients treated with radiation, and the results will help in understanding the potential factors that influence survival for patients with HCC after EBRT.
- Subjects :
- Adult
Male
Cancer Research
medicine.medical_specialty
Carcinoma, Hepatocellular
Lung Neoplasms
Time Factors
Adolescent
medicine.medical_treatment
Vena Cava, Inferior
Inferior vena cava
Cohort Studies
Young Adult
medicine
Humans
Neoplasm Metastasis
Thrombus
Child
Survival analysis
Aged
Aged, 80 and over
Portal Vein
business.industry
Liver Neoplasms
Dose-Response Relationship, Radiation
Thrombosis
General Medicine
Middle Aged
Prognosis
medicine.disease
Survival Analysis
Radiation therapy
Treatment Outcome
Oncology
medicine.vein
Hepatocellular carcinoma
Multivariate Analysis
cardiovascular system
Female
Radiology
Liver cancer
business
Progressive disease
Follow-Up Studies
Subjects
Details
- ISSN :
- 13497006 and 13479032
- Volume :
- 99
- Database :
- OpenAIRE
- Journal :
- Cancer Science
- Accession number :
- edsair.doi.dedup.....4cb46a49401a706c1939d5f03951e0ab