| Efficacy of Radiotherapy in Combination with Immune Checkpoint Blockade for Hepatocellular Carcinoma and Portal Vein Tumor Thrombosis |
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Yunjeong Lee1, Minkyung Park1, Eun Sun Jang1, Gwanghyun Choi1, Sook-Hyang Jeong1, Jin Won Kim2, Minsu Kang2, Jee Hyun Kim2, Changhoon Song3, Kyubo Kim3, Jin-Wook Kim1 |
1Department of Gastroenterology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
2Department of 2Hematology and Medical Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
3Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea |
| 문맥 종양 혈전을 동반한 간세포암에서 방사선 치료와 면역관문억제제 병합 요법의 효과 |
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이윤정1, 박민경1, 장은선1, 최광현1, 정숙향1, 김진원2, 강민수2, 김지현2, 송창훈3, 김규보3, 김진욱1 |
1서울대학교 의과대학 분당서울대학교병원 소화기내과
2서울대학교 의과대학 분당서울대학교병원 혈액종양내과
3서울대학교 의과대학 분당서울대학교병원 방사선종양학과 |
Correspondence:
Jin-Wook Kim, Tel: +82-31-787-7009, Fax: +82-31-787-4051, Email: kimjinw@snu.ac.kr
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Received: 7 April 2025 • Revised: 16 May 2025 • Accepted: 2 June 2025 |
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| Abstract |
Background/Aims
Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is associated with poor prognosis and low response rates to standard atezolizumab plus bevacizumab therapy (atezo/bev). This study aimed to evaluate the safety and efficacy of radiation therapy (RT) in patients with HCC and PVTT receiving atezo/bev treatment.
Methods
This retrospective cohort study included patients with HCC and PVTT treated at a tertiary referral center in Korea. Eligible patients had Child-Pugh class A liver function and an Eastern Cooperative Oncology Group performance status of ≤ 1, and were not candidates for surgical resection or loco-regional therapies. Cox regression analysis was used to identify predictors of progression-free survival (PFS) and overall survival (OS).
Results
A total of 85 patients were included, 55 of whom received atezo/bev alone and 30 received atezo/bev combined with RT. There was no significant difference in disease control rate between the two groups (25% vs. 30%, p = 0.65), nor in PFS or OS (median PFS, 143 vs. 289 days, p = 0.17; median OS, 293 vs. 416 days, p = 0.16). However, subgroup analysis, excluding patients with main portal trunk invasion, showed that the addition of RT significantly improved both PFS (adjusted hazard ratio [aHR], 0.29; p = 0.002) and OS (aHR, 0.33; p = 0.01). No clinical or laboratory deteriorations were observed after RT.
Conclusions
These findings suggest that the addition of RT to PVTT may be beneficial in patients with preserved liver function without main portal vein involvement. |
| Key Words:
Carcinoma, hepatocellular; Atezolizumab; Bevacizumab; Radiation; Portal vein thrombosis |
| 주제어:
간세포암; 아테졸리주맙; 베바시주맙; 방사선 치료; 간문맥 혈전증 |
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