Work

Co-radiotherapy with tyrosine kinase inhibitors might benefit survival in hepatoma patients with portal vein tumor thrombosis

Year: 2025

Type: article

Abstract: Hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) is associated with a poor prognosis, and current treatment options yield suboptimal results. This article aims to share our treatment outcomes for PVTT using tyrosine kinase inhibitors (TKIs), radiation therapy (RT), and their combination. From 2010 to 2021, a total of 160 Child-Pugh class A HCC patients with PVTT, but without extrahepatic spread, were enrolled. Among them, 26, 10, 81, and 43 patients underwent no treatment, RT, TKIs, and combination therapy, respectively. Compared to the no treatment group (median survival: 2 months), the RT group (4.5 months, p=0.034), TKIs group (5.0 months, p=0.0017), and combination group (15.0 months, p<0.001) all demonstrated a survival benefit. The multivariate Cox model showed adjusted hazard ratios and 95% confidence intervals of 0.35 (0.16–0.78), 0.40 (0.25–0.63) and 0.26 (0.15–0.44) for RT, TKIs, combination groups, respectively. From clinical observation of patients who survived for two years, we found that 20% of RT patients achieved good local control, and the RT group had longer durations of TKI use. In this series, 26.9% (43/160) of HCC patients with PVTT underwent combination treatment with TKIs and RT, achieving a median survival of 15.0 months. The contributions of RT were 20% disease control rate and may extend the duration of TKIs use. Therefore, all candidates without contraindications should be considered for combination treatment. This real-world study from an Eastern hospital revealed 26.9% (43/160) Child-Pugh A hepatocellular carcinoma patients with portal vein tumor thrombus underwent combination treatment of tyrosine kinase inhibitors and radiation therapy, achieved median survival of 15.0 months. The contributions of RT were 20% disease control rate and may extend the duration of TIKs use. All candidates without any contraindication should be considered for combination treatment.

Source: Biomedical Journal

DOI: 10.1016/j.bj.2025.100904

Authors: Hui-Ling Huang, Wei-Ming Lin, Chia-Hsuan Lai, Te-Sheng Chang, Sheng-Nan Lu

Institutions: Chang Gung Memorial Hospital, Chiayi Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital

Language: English

Topic: Hepatocellular Carcinoma Treatment and Prognosis

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,700