Efficacy of stereotactic radiotherapy for patients with primary hepatocellular carcinoma and portal vein tumor thrombosis

XUE Hui; LIU Hu; HAN ping; ZHANG Ai-min; LI Wen-gang; LIU Li-ying; DUAN Xue-zhang

doi:10.3969/j.issn.1007-8134.2016.04.008

Abstract：ObjectiveTo explore the efficacy of stereotactic radiotherapy (cyberknife therapy)for patients with primary hepatocellular carcinoma and portal vein tumor thrombosis.MethodsFifty-nine cases of patients, who were hospitalized from January 2011 to May 2015, with primary hepatocellular carcinoma and portal vein tumor thrombosis were enrolled into this study, and all patients were treated with cyberknife therapy. The gross tumor volume (GTV) of patients ranged from 24.6 cm3 to 1265.0 cm3, the median was 399.02 cm3, the fractionated dose ranged from 5 Gy to 13 Gy( the median was 10Gy), the tumor treatment dose f ranged from 35 Gy to 56 Gy(the median was 49 Gy ), divided into 4-8 fractions (the median was 6). All patients received cyberknife therapy every day or every other day. The survival data were analyzed by life table method, and the influencing factors were analyzed by Cox regression model. ResultsFifty-nine patients all received cyberknife therapy, the median progression free survival for these patients was 5.19 months, the median overall survival was 11.84 months. In the local control rate of these patients, disease control rate is 62.71% (37/59). The overall survival rates at year 1, 2 and 3 after treatment were 49.15% (29/59), 20.34% (12/59) and 11.86% (7/59). Cox multiple factor analysis showed that AFP before radiotherapy, sex, age, tumor size, tumor number, liver function, ascites, thrombosis type and dosage were not related to the patients’ survival.ConclusionsAs for patients with primary hepatocellular carcinoma and portal vein tumor thrombosis, cyberknife therapy is an ideal treatment which can markedly prolong the overall survival.