Efficacy of radiotherapy for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombosis

Background: the to investigate the feasibility, efficacy, and toxicity of threedimensional conformal radiotherapy (3d-crt) for treatment of patients with advanced hepatocellular carcinoma (hcc) complicated by portal vein tumor thrombosis (pvtt) and/or inferior vena cava tumor thrombosis (ivctt). materials and methods: 53 hcc patients with pvtt/ivctt undergoing 3d-crt during the period from september 2008 to january 2014 were analyzed. the kaplan-meier method was used to analyze between-group differences in patient baseline information. univariate and multivariate cox regression analyses were used to identify factors affecting survival in patients with hcc. results: computed tomography (ct) scan or mri (magnetic resonance imaging) of the upper abdomen one month post-radiotherapy showed an overall response rate (cr + pr) of 56.6% (30/53). univariate analysis revealed that treatment regimen (p = 0.008), alpha fetoprotein (afp) level (p = 0.012), response to radiotherapy, metastasis to celiac lymph nodes and site of tumor thrombosis were strongly associated with the prognosis of hcc patients with pvtt (p = 0.000). the median survival time was 9 months (95% ci: 7.43-10.57 months) in 23 (43.4%) pvtt patients, and 24 months (95% ci: 20.04-27.96 months) in 30 (56.6%) ivctt patients. multivariate cox regression analysis revealed that metastasis to celiac lymph nodes (p = 0.004) and response to radiotherapy (p = 0.001) were independent factors affecting patients’ survival. conclusion: 3d-crt has high efficacy for treating hcc patients with pvtt, and metastasis to celiac lymph nodes and response to radiotherapy are primary factors affecting hcc patients’ survival.