The efficacy of radiotherapy in association with multidisciplinary treatment for portal tumor emboli of hepatocellular carcinoma

Purpose: To evaluate the efficacy of radiotherapy for portal tumor emboli of hepatocellular carcinoma. Materials and Methods: Twenty-four patients with portal tumor emboli of hepatocellular carcinoma who were treated with radiotherapy from August 1995 to December 1999 were retrospectively studied. Patients were classified according to the degree of portal tumor emboli (Vp2: 3. Vp3: 14. Vp4: 7) and liver damage (A: 8, B: 11, C: 4. unknown: 1). The responses were classified as effective, no change, or progression. The liver function between pre- and post-radiotherapy was compared. Results: The responses were effective for 12 cases (75%) and no change for 4 cases (25%). Cause specific survival rate at 1 year and 50% survival time was 24.4% and 6.3 months, respectively. Cause specific survival rate at 1 year for liver damage A and Vp3 were 60% and 38% respectively. 50% survival time for liver damage A and Vp3 were 11 months and 11.3 months respectively. Prolongation of the prognosis over 6 months was observed in a few cases of liver damage B. Liver function with local irradiation was generally tolerable. Conclusions: Radiotherapy for portal tumor emboli of hepatocellular carcinoma was useful as one of multimodality treatments for advanced hepatocellular carcinoma. This treatment sometimes expected prolongation of the prognosis for hepatocellular carcinoma with portal tumor emboli.