In HCC with portal vein tumor thrombus, this neoadjuvant therapy improves survival

  • Wei X & al.
  • J Clin Oncol
  • 8 juil. 2019

  • Par Jim Kling
  • Résumés d'articles
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Takeaway

  • Neoadjuvant 3D conformal radiotherapy led to better survival than surgery alone in patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).

Why this matters

  • A previous, retrospective analysis had suggested that neoadjuvant 3D conformal radiotherapy may be effective in HCC with PVTT. This randomized trial provides direct evidence.

Study design

  • Open-label, randomized controlled trial (n=164).
  • Funding: Various nonindustry sources.

Key results

  • Overall response rate was 20.7% in the radiotherapy group.
  • OS was better in the radiotherapy group (P<.001 style="list-style-type:circle;">
  • 6 months: 89.0% vs 81.7%.
  • 12 months: 75.2% vs 43.1%.
  • 18 months: 43.9% vs 16.7%.
  • 24 months: 27.4% vs 9.4%.
  • Disease-free survival was better in the radiotherapy group (P=.009):
    • 6 months: 56.9% vs 42.1%.
    • 12 months: 33.0% vs 14.9%.
    • 18 months: 20.3% vs 5.0%.
    • 24 months: 13.3% vs 3.3%.
  • Limitations

    • Study was not blinded.
    • Chinese population.