Copyright
©The Author(s) 2016.
World J Gastroenterol. Aug 28, 2016; 22(32): 7289-7300
Published online Aug 28, 2016. doi: 10.3748/wjg.v22.i32.7289
Published online Aug 28, 2016. doi: 10.3748/wjg.v22.i32.7289
Table 1 Common classifications of portal vein tumor thrombosis in hepatocellular carcinoma
Group | Types of PVTT | Survival |
Ikai et al[80] | Vp0: Absent | 59% at 5 yr |
Vp1: Distal to but not in second-order branches | 39.1% at 5 yr | |
Vp2: In second-order branches | 23.3% at 5 yr | |
Vp3: In first-order branches | 18.3% at 5 yr (Vp3 and Vp4) | |
Vp4: In the main trunk or contralateral or both | ||
Shi et al[17] | 10: Microscopic | |
1: In segmental branches or above | 26.7% at 3 yr (Type 10 included) | |
2: In the left or right branch | 16.9% at 3 yr | |
3: In the main trunk | 3.7% at 3 yr | |
4: In the superior mesenteric vein | 0% at 3 yr | |
Xu et al[18] | A: In the main trunk or both the left and right branches | 0% at 5 yr |
B: In only the left or right branch | 5.2% at 5 yr |
Table 2 Prospective trials on transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombosis
Group | No. of patients | Treatments | Child-Pugh A | Survival |
Luo et al[81] | 164 (84 vs 80) | TACE vs Control | Not known | 1-yr survival 30.9% vs 9.2% |
Niu et al[82] | 150 (115 vs 35) | TACE vs Control | 88 vs 21 | Median survival 8.67 mo vs 14 mo |
Kim et al[83] | 110 (49 vs 61) | TACE vs TACI | 30 vs 22 | Median survival 14.9 mo vs 4.4 mo |
Peng et al[25] | 603 (402 vs 201) | TACE vs Resection | 389 vs 197 | Median survival 42 mo vs 14.1 mo |
Table 3 Studies on radiation therapy for hepatocellular carcinoma with portal vein tumor thrombosis
n | Treatment | Total RT dose/fractional dose (in Gy) | Response rate (CR + PR, %) | Median survival (mo) | Toxicity grade≥3 (%) | Ref. |
45 | 3D-CRT (+TACE/PEI/RFA; 7% RT only) | 38-65/1.8-2.5 | 62.3 (CR 6.7) | 11.2 | 2 | Rim et al[51] |
412 | 3D-CRT + TACE | 21-60/2-5 | 27.9 (CR 3.6) | 10.6 | 10 | Yoon et al[44] |
40 | IGRT + IA 5FU/IFN vs IA 5FU/IFN | 30-48/7-16 | 60 (CR 5) | 12 (RT) | 15 | Chuma et al[52] |
9.1 (non-RT) | ||||||
32 | IA 5FU/IFN + 3D-CRT vs IA 5FU/IFN | 30-45/3 | 75 (CR 19) | 7.5 (RT) | G4: 2 | Katamura et al[46] |
7.9 (non-RT) | G3: 7% (leucopenia)/6% (thrombocytopenia)/1 (anorexia) | |||||
45 | PV stenting + TACE + 3D-CRT vs PV stenting + TACE | 30-60/2 | 35.6 (CR 0) | 16.5 (RT) | 0 | Zhang et al[45] |
4.8 (non-RT) | ||||||
326 | 3D-CRT (IMRT 14.1%) | 60/2-3 | 18.1 (CR 5.8) | 4 | 0 | Huang et al[53] |
38 | 3D-CRT | 17.5-50.4/1.8-4 | 44.7 (CR 15.8) | 9.6 | 0 | Toya et al[47] |
59 | 3D-CRT | 30-54/2-3 | 45.8 (CR 6.8) | 7.8 | 0 | Kim et al[48] |
44 | RT + TACE | 36-60/2 | 45.5 (CR 34.1) | 8 | 0 | Kim et al[49] |
19 | 3D-CRT (+ TACE for liver tumor) | 46-60/2 | 57.9 (CR 0) | 7 | G3: 5% (thrombocytopenia)/2% (leucopenia)/2 (GI ulcers) | Yamada et al[54] |
20 | RT + TACE | 50/2 | 50 (CR 0) | 5.3 | 5 | Ishikura et al[55] |
24 | RT + TACE | 50/2 | 50 (CR 16.7) | CR/PR (9.7) | 13% | Tazawa et al[56] |
NR/PD (3/8) | ||||||
281 | 3D-CRT + TACE | 30-54/1.8 -4.5 | 53.8 (CR 3.6) | 11.6 | 20% | Yu et al[57] |
- Citation: Chan SL, Chong CC, Chan AW, Poon DM, Chok KS. Management of hepatocellular carcinoma with portal vein tumor thrombosis: Review and update at 2016. World J Gastroenterol 2016; 22(32): 7289-7300
- URL: https://www.wjgnet.com/1007-9327/full/v22/i32/7289.htm
- DOI: https://dx.doi.org/10.3748/wjg.v22.i32.7289