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Role of rapid arc-image-guided radiotherapy in hepatocellular carcinoma with portal vein tumor thrombosis: A study from tertiary care center in Punjab, India


1 Department of Radiation Oncology, DMCH Cancer Center, Ludhiana, Punjab, India
2 Department of Radiology, SPS Hospital, Ludhiana, Punjab, India
3 Department of Medical Physics, DMCH Cancer Center, Ludhiana, Punjab, India

Correspondence Address:
Manjinder Singh Sidhu,
Department of Radiation Oncology, DMCH Cancer Center, Ludhiana, Punjab
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.jcrt_365_21

Background and Objectives: Treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) is very challenging with poor outcome. In this situation, radiotherapy has become an alternative treatment modality, more precisely due to advances in radiation techniques. The goal of our study is to do analysis of these patients treated with rapid arc image-guided technology (RA-IGRT) at our institution. Materials and Methods: Thirteen patients were included in the study. As per intuition policy, patient set up, contouring, and treatment plans were generated. Radiological response assessment was done 1-month post-radiotherapy. Survival analysis curve along with Chi-square test for prognostic factors assessment was done using SPSS. Results: With median dose of 45 Gy in 20 fractions, we were able to achieve 27.3% objective response rate with median survival of 5 months in eligible patients. Conclusions: One-year overall survival up to 30% can be achieved in HCC with PVTT, especially in patients with objective response to radiotherapy with Japan Integrated Staging score 2, provided it is precisely hit by RA-IGRT.


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