Portal Vein Irradiation Stent Plus Chemoembolization versus External Radiotherapy Plus Chemoembolization in Hepatocellular Carcinoma with Portal Vein Tumour Thrombus: A Retrospective Study.

Abstract

PURPOSE:

To compare the clinical outcomes of portal vein irradiation stent implantation (PVIS) plus transcatheter arterial chemoembolization (TACE) and radiotherapy (RT) plus TACE in hepatocellular carcinoma (HCC) with portal vein tumour thrombus (PVTT).

METHODS:

Data from 79 patients with HCC complicated by PVTT treated with PVIS implantation plus TACE (n = 53) or treated with RT plus TACE (n = 26) were retrospectively analysed. The primary outcome measure was overall survival, and the secondary outcome was the stent patency period. HCC response and complications were evaluated.

RESULTS:

At a median follow-up of 14.3 (range, 1.2 ~ 60) months, the median OS was 13.1 (95% CI: 9.8 ~ 16.4) months in the PVIS plus TACE group compared to 8.0 (95% CI: 6.1 ~ 9.9) months in the RT plus TACE group (p = 0.021). Stent occlusion was observed in 11 patients with a median patency time of 8.5 (range, 2 ~ 22) months. Multivariate Cox regression analysis demonstrated that Vp4 PVTT (HR: 5.22; 95% CI: 1.74-15.74) and poor response to therapy (HR: 4.89; 95% CI: 2.66-8.99) were independent risk factors for OS, whereas PVIS plus TACE treatment (HR: 0.32; 95% CI: 0.18-0.56) was related to better prognosis. None of the patients in the two groups had grade 3-4 complications.

CONCLUSION:

In conclusion, this retrospective study shows that PVIS plus TACE provides a significantly better survival outcome than RT plus TACE for HCC patients with PVTT.

• Authors: Zhongbao Tan, Jian Lu, Guangyu Zhu, Li Chen, Yong Wang, Qi Zhang, Tao Pan, Junying Wang, Jinhe Guo, Gaojun Teng
• Journal: Cardiovascular and interventional radiology (Cardiovasc Intervent Radiol) Vol. 44 Issue 9 Pg. 1414-1422 (Sep 2021) ISSN: 1432-086X [Electronic] United States
• PMID: 34131776 (Publication Type: Journal Article)
• Copyright: © 2021. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).

Topics

• Carcinoma, Hepatocellular (complications, therapy)
• Chemoembolization, Therapeutic
• Combined Modality Therapy
• Humans
• Liver Neoplasms (complications, therapy)
• Portal Vein (diagnostic imaging)
• Retrospective Studies
• Stents
• Thrombosis
• Treatment Outcome