Comparison of radiation therapy modalities for hepatocellular carcinoma with portal vein thrombosis: A meta-analysis and systematic review. Issue 1 (October 2018)

• Record Type: Journal Article
• Authors: Rim, Chai Hong; Kim, Chul Yong; Yang, Dae Sik; Yoon, Won Sup
• Is Part Of: Radiotherapy and oncology. Volume 129:Issue 1(2018)
• Page Start: 112
• Page End: 122
• Publication Date: 2018-10
• Subjects: Radiotherapy -- Hepatocellular carcinoma -- Portal vein thrombosis -- Selective internal radiotherapy -- Stereotactic body radiotherapy; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2017.11.013
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: Purpose: We performed a meta-analysis and systematic review to compare the radiotherapy (RT) modalities for hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT). Materials and methods: We searched the PubMed, EMBASE, Medline, and Cochrane library databases. The primary endpoint was the 1-year overall survival (OS), and response rate (RR), local control (LC), 2-year OS, and grade ≥3 toxicity incidence were evaluated as secondary endpoints. Results: Thirty-seven studies comprising 2513 patients were included. The pooled 1-year OS rates for the 3-dimensional conformal RT (3DCRT), selective internal RT (SIRT), and stereotactic body RT (SBRT) groups were 43.8% [95% confidence interval (CI): 37.6–50.2], 46.5% (95% CI: 37.7–55.6), and 48.5% (95% CI: 39.4–57.8). These inter-group differences were not statistically significant ( p = 0.635). The pooled response rates were 51.3% (95% CI: 45.7–57.0), 33.3% (95% CI: 18.0–53.2), and 70.7 (95% CI: 63.7–76.8) for 3DCRT, SIRT, and SBRT groups, respectively; p = 0.001 and 0.031 for 3DCRT vs. SBRT and SIRT, respectively. The most common grade ≥ 3 complications were lymphocytopenia and bilirubin abnormalities in the 3DCRT and SIRT groups, respectively. Grade ≥ 3 complication was rare in SBRT group. Conclusions: OS did not differ among the modalities, although the response rates vary among modalities.