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HOME > J Liver Cancer > Volume 18(2); 2018 > Article
Original Article Multicenter Planning Comparison of Stereotactic Body Radiotherapy for Hepatocellular Carcinoma with Major Portal Vein Tumor Thrombosis (KROG 16-17)
Bae, Sun Hyun , Kim, Mi Sook , Jang, Won Il , Kim, Jin Ho , Kim, Woo Chul , Kim, Jin Hee , Jeong, Bae Kwon , Kim, Yong Ho , Jo, Sunmi , Choi, Chul Won , Park, Younghee , Cho, Kwang Hwan
Journal of Liver Cancer 2018;18(2):130-141
DOI: https://doi.org/10.17998/jlc.18.2.130
Published online: September 30, 2018
1Department of Radiation Oncology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
2Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea. mskim@kcch.re.kr
3Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
4Department of Radiation Oncology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
5Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
6Department of Radiation Oncology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
7Department of Radiation Oncology, Catholic Kwandong University International St. Mary's Hospital, Incheon, Korea.
8Department of Radiation Oncology, Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea.
9Department of Radiation Oncology, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea.
10Department of Radiation Oncology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
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Background/Aims
To evaluate the technical feasibility of stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC) with the major portal vein tumor thrombosis (PVTT).
Methods
Ten institutions affiliated with the Korean Stereotactic Radiosurgery Group were provided the contours of four cases: the first case was the first branch PVTT with sufficient normal liver volume (NLV), the second was the first branch PVTT with insufficient NLV, the third was the main trunk PVTT at confluence level, and the fourth was the main trunk PVTT with entire length. The institutions were asked to make SBRT plans according to their current treatment protocols and to complete facility questionnaires.
Results
Based on institutional protocols, SBRT was feasible in nine institutions for the first case (32-60 Gy in 3-5 fractions), in eight institutions for the second case (32-50 Gy in 3-5 fractions), in seven institutions for the third case (35-60 Gy in 3-5 fractions), and in four institutions for the fourth case (35-42 Gy in 4-5 fractions). The other institutions recommended hypo- or conventional fractionation due to insufficient NLV or gastrointestinal organ proximity. With analysis of the SBRT dose to the central hepatobiliary tract, the major PVTT could theoretically be associated with a high risk of hepatobiliary toxicity.
Conclusions
Although SBRT is a technically feasible option for HCC with the major PVTT, there was a variability among the participating institutions. Therefore, further studies will be necessary to standardize the practice of SBRT for the major PVTT.


JLC : Journal of Liver Cancer