The role of radioTherapy in The TreaTmenT of hepaTocellular carcinoma wiTh inferior vena cava Tumor Thrombosis

Purpose : To evaluate the role of radiotherapy in treatment of hepatocellular carcinoma (HCC) with inferior vena cava tumor thrombosis (IVCTT) and the prognostic factors for overall survival. Materials and Methods : Twenty-two patients with HCC and IVCTT referred for radiotherapy between 2006 and 2009 were retrospectively reviewed. A total of 60 Gy in 30 daily fractions was delivered with intensity-modulated radiotherapy techniques. Patient-related and treatment-related factors were analyzed to evaluate their prognostic significance for overall survival rate. Results : Complete response was noted in 7 patients and partial response in 6 patients. The 1-year, 2-year overall survival rates were 40.9 %, 22.7% and the median survival was 8 months for the entire cohort of patients. Objective response (complete or partial response) to radiotherapy was the only prognostic factor for overall survival. For patients with objective response to radiotherapy, the median survival was 16.9 months and the 1-year overall survival rate was 53.8%, compared to 4.7 months and 22.2% of those without objective response (p =0.004). Conclusions : Our results showed that radiotherapy achieved a high objective response rate and prolonged survival in patients with HCC and IVCTT. Patients with response to radiotherapy have favorable prognosis than their counterpart. Radiotherapy could be considered as an effective palliative treatment option for patients with HCC and IVCTT.