Combined endovascular brachytherapy, sorafenib, and transarterial chemobolization therapy for hepatocellular carcinoma patients with portal vein tumor thrombus

作     者：Zi-Han Zhang Qing-Xin Liu Wen Zhang Jing-Qin Ma Jian-Hua Wang Jian-Jun Luo Ling-Xiao Liu Zhi-Ping Yan 

作者机构：Department of Interventional RadiologyZhongshan HospitalFudan University and Shanghai Institute of Medical Imaging 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第43期

页      面：7735-7745页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by the Project of Advanced and Appropriate Technique Generalization of Shanghai Health and Family Planning Committee,No.2013SY060 the Scientific Program of Shanghai Municipal Heath Bureau,No.20124188 

主　　题：Hepatocellular carcinoma Transarterial chemoembolization Endovascular brachytherapy Main portal vein tumor thrombus Sorafenib 

摘      要：AIM To evaluate the safety and efficacy of combined endovascular brachytherapy(EVBT),transarterial chemoembolization(TACE),and sorafenib to treat hepatocellular carcinoma(HCC) patients with main portal vein tumor thrombus(MPVTT).METHODS This single-center retrospective study involved 68 patients with unresectable HCC or those who were unfit for liver transplantation and percutaneous frequency ablation according to the BCLC classification. All patients had Child-Pugh classification grade A or B,Eastern Cooperative Oncology Group(ECOG)performance status of 0-2,and MPVTT. The patients received either EVBT with stent placement,TACE,and sorafenib(group A,n = 37),or TACE with sorafenib(group B,n = 31). The time to progression(TTP) and overall survival(OS) were evaluated by propensity score *** In the entire cohort,the 6-,12-,and 24-mo survival rates were 88.9%,54.3%,and 14.1% in group A,and 45.8%,0%,and 0% in group B,respectively(P 0.001). The median TTP and OS were significantly longer in group A than group B(TTP: 9.0 mo vs 3.4 mo,P 0.001; OS: 12.3 mo vs 5.2 mo,P 0.001). In the propensity score-matched cohort,the median OS was longer in group A than in group B(10.3 mo vs 6.0 mo,P 0.001). Similarly,the median TTP was longer in group A than in group B(9.0 mo vs 3.4 mo,P 0.001). Multivariate Cox analysis revealed that the EVBT combined with stent placement,TACE,and sorafenib strategy was an independent predictor of favorable OS(HR = 0.18,P 0.001). CONCLUSION EVBT combined with stent placement,TACE,and sorafenib might be a safe and effective palliative treatment option for MPVTT.