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Japanese Journal of Clinical Oncology Advance Access originally published online on May 21, 2008
Japanese Journal of Clinical Oncology 2008 38(6):438-444; doi:10.1093/jjco/hyn038
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© The Author (2008). Published by Oxford University Press. All rights reserved

Three-dimensional Conformal Radiotherapy for Hepatocellular Carcinoma with Inferior Vena Cava Invasion

Hiroshi Igaki1, Keiichi Nakagawa1, Kenshiro Shiraishi1, Shuichiro Shiina2, Norihiro Kokudo3, Atsuro Terahara1, Hideomi Yamashita1, Nakashi Sasano1, Masao Omata2 and Kuni Ohtomo1

1 Departments of Radiology
2 Gastroenterology
3 Hepato-Biliary-Pancreatic Surgery, The University of Tokyo Hospital, Tokyo, Japan

For reprints and all correspondence: Hiroshi Igaki, Department of Radiology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. E-mail: igaki-tky{at}umin.ac.jp

Received February 25, 2008; accepted April 24, 2008

Background: Hepatocellular carcinoma with inferior vena cava invasion is a rare but fatal condition of disease progression. The aim of this study was to analyze the results of treatment for hepatocellular carcinoma with inferior vena cava invasion by three-dimensional conformal radiation therapy.

Methods: From 1990 to 2006, 18 histopathologically confirmed hepatocellular carcinoma patients with inferior vena cava invasion who were unsuitable for surgery were treated by three-dimensional conformal radiation therapy at our hospital with two to four static or dynamic conformal arc fields.

Results: A median total tumor dose of 50 Gy (range 30–60 Gy) was delivered. The progression-free rate was 91.6% among the patients in whom follow-up computed tomography was obtained. Actuarial survival at 1 year was 33.3%, and the median survival period was 5.6 months.

Conclusions: Three-dimensional conformal radiation therapy might offer a chance of long survival for a part of the hepatocellular carcinoma patients with inferior vena cava invasion, since a third of such patients survived more than a year. Additional treatments should be considered to prevent distant metastases and hepatic functional deterioration after three-dimensional conformal radiation therapy.

Key Words: hepatocellular carcinoma • inferior vena cava • three-dimensional conformal radiation therapy • hepatic functional reserve • liver cirrhosis


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