Table 2.
Demographic, disease and treatment characteristics of patients treated with external beam radiation for hepatocellular carcinoma portal vein tumor thrombus.
| All patients (N = 34) | Patients treated with BED ≤75 Gy (N = 17) | Patients treated with BED >75 Gy (N = 17) | P-value | |
|---|---|---|---|---|
| Gender; N (column %) | .146 | |||
| Men | 29 (85%) | 16 (94%) | 13 (77%) | |
| Women | 5 (15%) | 1 (6%) | 4 (23%) | |
| Age at EBRT start in years; | .085 | |||
| mean ± SD | 62.6 ± 8.5 years | 60.0 ± 6.3 years | 65.2 ± 9.7 years | |
| median [range] | 62.5 [44–80] | 61 [45–70] | 65 [44–80] | |
| KPS at EBRT; | .192 | |||
| mean ± SD | 85 ± 9 | 83 ± 10 | 87 ± 8 | |
| median [range] | 90 [60–100] | 80 [60–100] | 90 [70–100] | |
| Underlying liver disease; N (column %) | .490 | |||
| None | 3 (9%) | 2 (12%) | 1 (6%) | |
| Cirrhosis, unknown etiology | 7 (21%) | 2 (12%) | 5 (29%) | |
| Hepatitis B and/or C | 19 (56%) | 10 (65%) | 8 (47%) | |
| Alcoholic cirrhosis | 1 (3%) | 0 (0%) | 1 (6%) | |
| NASH | 3 (9%) | 2 (12%) | 1 (6%) | |
| Alpha 1 antitrypsin deficiency | 1 (3%) | 0 (0%) | 1 (6%) | |
| Childs Pugh Score; N (column %) | .098 | |||
| 5A | 21 (62%) | 11 (65%) | 10 (59%) | |
| 6A | 10 (29%) | 3 (18%) | 7 (41%) | |
| 7B | 3 (9%) | 3 (18%) | 0 (0%) | |
| AFP in IU/mL; | .050 | |||
| mean ± SD, | 6350 ± 26517 | 11670 ± 36624 | 697 ± 1801 | |
| median [range] | 48 [1.7–152352] | 503 [1.7–152342] | 14 [2.7–6691] | |
| Location of PVTT; N (column %) | .460 | |||
| Main PV | 12 (35%) | 7 (41%) | 5 (29%) | |
| R proximal PV | 9 (26%) | 3 (18%) | 6 (35%) | |
| L proximal PV | 7 (21%) | 5 (29%) | 2 (12%) | |
| R segmental PV | 4 (12%) | 1 (6%) | 3 (18%) | |
| L segmental PV | 2 (6%) | 1 (6%) | 1 (6%) | |
| T-stage; N (column %) | .194 | |||
| T1 | 2 (6%) | 1 (6%) | 1 (6%) | |
| T2 | 6 (18%) | 1 (6%) | 5 (29%) | |
| T3 | 26 (76%) | 145(88%) | 11 (65%) | |
| N-stage; N (column %) | .146 | |||
| N0 | 29 (85%) | 13 (76%) | 16 (94%) | |
| N1 | 5 (15%) | 4 (24%) | 1 (6%) | |
| M-stage; N (column %) | .310 | |||
| M0 | 33 (97%) | 17 (100%) | 16 (94%) | |
| M1 | 1 (3%) | 0 (0%) | 1 (6%) | |
| Prior treatment*; N (column %) | .473 | |||
| None | 12 (35%) | 7 (41%) | 5 (29%) | |
| TACE | 16 (47%) | 6 (35%) | 10 (59%) | |
| RFA | 4 (12%) | 2 (12%) | 2 (12%) | |
| Systemic therapy | 15 (44%) | 9 (53%) | 6 (35%) | |
| Radiation modality; N (column %) | .028 | |||
| 3DCRT | 3 (9%) | 2 (12%) | 1 (6%) | |
| IMRT | 22 (65%) | 14 (82%) | 8 (47%) | |
| PBR | 6 (18%) | 1 (6%) | 5 (29%) | |
| SBRT | 3 (9%) | 0 (0%) | 3 (18%) | |
| Gross tumor volume target in cubic centimeters; | .003 | |||
| mean ± SD, | 274 ± 254 | 357 ± 251 | 187 ± 235 | |
| median [range] | 189 [131–339] | 261 [188–456] | 137 [42–192] | |
| Radiation dose in Gy; | <0.001 | |||
| mean ± SD, | 55 ± 9 | 48.0 ± 4.9 | 62.1 ± 7.4 | |
| median [range] | 55 [40–75] | 45 [40–57.5] | 62.5 [45–75] | |
| Number of fractions; | .074 | |||
| mean ± SD, | 19 ± 8 | 22 ± 6 | 17 ± 8 | |
| median [range] | 17.5 [3–30] | 25 [10–28] | 15 [3–30] | |
| BED in Gy; | <0.001 | |||
| mean ± SD | 77 ± 25 | 59 ± 7 | 94 ± 24 | |
| median [range] | 75 [47–180] | 59 [47–75] | 86 [76–180] | |
| Breath-hold technique; N (column %) | 1.00 | |||
| Yes | 16 (47%) | 8 (47%) | 8 (47%) | |
| No | 18 (53%) | 9 (53%) | 9 (53%) | |
| CT-on rails image guidance; N (column %) | .724 | |||
| Yes | 12 (38%) | 6 (35%) | 7 (41%) | |
| No | 21 (62%) | 11 (65%) | 10 (59%) | |
| Concurrent chemotherapy; N (column %) | .015 | |||
| None | 22 (65%) | 7 (41%) | 15 (88%) | |
| Nexavar | 8 (24%) | 7 (41%) | 1 (6%) | |
| Xeloda | 4 (12%) | 3 (18%) | 1 (6%) |
BED = biologically effective dose; Gy = Gray; EBRT = external beam radiotherapy; SD = standard deviation; KPS = Karnofsky Performance Status; NASH = non-alcoholic hepatic steatosis; AFP = alpha-fetoprotein; IU/mL = international units per milliliter; PVTT = portal vein tumor thrombus; PV = portal vein; R = right; L = left; TACE = transarterial chemoembolization; RFA = radiofrequency ablation; 3DCRT = 3D conformal radiotherapy; IMRT = intensity-modulate radiotherapy; PBR = proton beam radiotherapy; SBRT = stereotactic body radiotherapy.
As some patients received more than one type of prior therapy, percentages do not add up to 100%.