JRSBRT 8.4, p. 257-264

An observational study on tumour response of portal vein tumour thrombus in hepatocellular carcinoma
Prateek Mehra, Tejinder Kataria, Deepak Gupta and Sonal Krishan

Objectives: Stereotactic body radiotherapy (SBRT) can sterilize the portal vein tumour thrombus (PVTT) and may make the patient eligible for liver transplant. We assessed the radiological response of PVTT after SBRT and check incidence of radiation induced liver disease (RILD).

Methods: PVTT treatment response was measured at 4-6 weeks as per mRECIST criteria, volume of PVTT and its enhancement in arterial phase. Biochemical data and Child-Pugh scoring (CPC) were evaluated to determine RILD incidence.

Results: 31 Patients were included. Complete response was seen in 5 patients (16.1%), partial response in 13 patients (41.9%), stable disease in 12 patients (38.7%). Mean volume of PVTT was 15.05 cc before SBRT and 7.83 cc afterwards (p = 0.001). The mean enhancement of the lesion was 86.19HU before SBRT vs 58.58HU after SBRT (p = 0.000). Two patients had grade 3 adverse events.

Conclusions: Volume, enhancement, and major axis length of PVTT showed statistically significant improvement after SBRT. No case had RILD after SBRT.

Keywords: SBRT, hepatocellular carcinoma, portal vein tumour thrombus, mRECIST