Combination Intensity-Modulated Radiotherapy and Sorafenib Improves Outcomes in Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Munire Abulimiti; Zhenyu Li; Haifeng Wang; Palida Apiziaji; Yisikandaer Abulimiti; Yao Tan

doi:10.1155/2021/9943683

Combination Intensity-Modulated Radiotherapy and Sorafenib Improves Outcomes in Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

J Oncol. 2021 Dec 3:2021:9943683. doi: 10.1155/2021/9943683. eCollection 2021.

Authors

Munire Abulimiti¹, Zhenyu Li², Haifeng Wang², Palida Apiziaji², Yisikandaer Abulimiti², Yao Tan²

Affiliations

¹ Department of Digestive Internal Medicine, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China.
² Department of Thoracic and Abdominal Radiotherapy, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China.

Abstract

Purpose: To compare the difference in outcome of hepatocellular carcinoma (HCC) with portal vein thrombosis (PVTT) between intensity-modulated radiotherapy (IMRT) concurrent with sorafenib and IMRT alone.

Methods: A total of 82 patients with PVTT from 2014 to 2019 were included. Of these, 36 received IMRT concurrent with sorafenib treatment (group A), while 46 underwent IMRT alone (group B). The dose of IMRT was 40.0-62.5 Gy/2-2.5 Gy/4-6 w, and patients received orally administered sorafenib 400 mg twice a day in combination with IMRT. Overall survival (OS), progression-free survival (PFS), and median distant metastasis-free survival (DMFS) were evaluated by using LIFETEST procedure of SAS.

Results: The median survival time was 11.0 months in group A versus 9.0 months in group B. The 1- and 2-year OS in group A were 44.9% and 3.8% versus 28.6% and 2.6% in group B (P=0.036), respectively. The median PFS was 6.0 months in group A versus 3.0 months in group B. The 1- and 2-year PFS in group A were 20.7% and 6.9% versus 2.7% and 0.0% in group B (P=0.012), respectively. The 1- and 2-year DMFS in group A were 38.0% and 7.9% versus 16.7% and 0.0% in group B (P=0.019), respectively. Multivariate analysis showed that Child-Pugh classification, AFP response, and overall response were independent risk factors for OS (P < 0.05). There were no significant differences in adverse events except fatigue and skin reactions between the two groups.

Conclusion: Compared with IMRT alone, IMRT concurrent with sorafenib can improve the long-term efficacy of HCC patients with PVTT, without increasing adverse reactions. The patients with Child-Pugh A, overall response, and AFP response obtained better OS.