Three-dimensional conformal radiotherapy to hepatocellular carcinoma associated portal vein tumor thrombosis: Safety profile and toxicity

In this study we aimed to determine safety profile and acute side effects of three-dimensional conformal radiotherapy (3DCRT) to portal vein tumor thrombus (PVTT) in cases of hepatocellular carcinoma (HCC). Thirty four consecutive patients were enrolled from Jan 2018 till Feb 2020; thirty of them fulfilled criteria for final analysis. Patients received 45Gy in 25 fractions to planning target volume (PTV). The median overall survival of the studied patients was 8.0 months. Responders had significant longer survival than non-responders (12 and 6 months respectively). No treatment related Grade 4 - 5 toxicity was observed. Only one patient (3.3 %) developed grade 3 elevation of bilirubin. Grade 1 nausea/vomiting were the most common side effect, it occurred in 22 patients (73.3%). Patients who didn't develop liver enzymes elevation, leukopenia or thrombocytopenia had better response and survival than patients who developed higher grades of toxicity. In addition to its survival benefit; 3DCRT to PVTT in cases of HCC is well tolerated with favorable toxicity profile.