Stereotactic body radiation therapy in patients with unresectable hepatocellular carcinoma and portal vein tumor thrombosis

Sep 28, 2026

Uploaded by Mary Man

About 35%-50% of hepatocellular carcinoma (HCC) patients present with portal venous tumor thrombosis (PVTT), where surgical options are limited. This retrospective single-institution study evaluated clinical characteristics and early outcomes of adults with unresectable HCC and PVTT treated with stereotactic body radiation therapy (SBRT). Treatment suitability required Child-Pugh A-B liver function and additional laboratory and performance criteria. Survival was analyzed with Kaplan-Meier methods and response at 3 months used RECIST 1.1. Thirty patients were included.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background

Aim

Methods

Results

Conclusion

Key Words

| W | J | H | World Journal of
Hepatology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Hepatol 2025 December 27; 17(12): 110993 DOI: 10.4254/wjh.v17.i12.110993 ISSN 1948-5182 (online) ORIGINAL ARTICLE Retrospective Study Stereotactic body radiation therapy in patients with unresectable hepatocellular carcinoma and portal vein tumor thrombosis Divya Khosla, Venkata Krishna Vamsi Gade, Rakesh Kapoor, Gaganpreet Singh, Ranjit Singh, Sunil Taneja, Madhumita Premkumar, Naveen Kalra, Arka De, Harish Bhujade, Nipun Verma, Ajay Duseja, Rajesh Gupta Specialty type: Oncology Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B, Grade B, Grade C Novelty: Grade B, Grade B, Grade D Creativity or Innovation: Grade B, Grade C, Grade D Scientific Significance: Grade B, Grade B, Grade C P-Reviewer: Balbaa M, PhD, Professor, Egypt; Li DM, MD, PhD, Postdoc, Postdoctoral Fellow, China Received: June 23, 2025 Revised: July 22, 2025 Accepted: November 11, 2025 Published online: December 27, 2025 Processing time: 189 Days and 2.4 Hours Divya Khosla, Venkata Krishna Vamsi Gade, Rakesh Kapoor, Gaganpreet Singh, Ranjit Singh, Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India Sunil Taneja, Madhumita Premkumar, Arka De, Nipun Verma, Ajay Duseja, Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India Naveen Kalra, Harish Bhujade, Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India Rajesh Gupta, Department of Gastrointestinal Surgery, Hepatopancreatobiliary, and Liver Transplantation, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India Co-first authors: Divya Khosla and Venkata Krishna Vamsi Gade. Co-corresponding authors: Divya Khosla and Rakesh Kapoor. Corresponding author: Divya Khosla, MD, Additional Professor, Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Room No. 54, Radiotherapy and Oncology Office, Ground Floor, Nehru Hospital Extension, Chandigarh 160012, [India.](India. dr_divya_khosla@yahoo.com)[ dr_divya_khosla@yahoo.com](India. dr_divya_khosla@yahoo.com) Abstract BACKGROUND About 35%-50% of patients with hepatocellular cancer (HCC) present with portal venous tumor thrombosis (PVTT) . Stereotactic body radiation therapy (SBRT) offers a promising approach for locoregional treatment in patients with HCC with PVTT. This study aimed to report the clinical characteristics and early outcomes of patients with unresectable HCC and PVTT treated with SBRT. AIM To report the clinical characteristics and early outcomes of patients with unresectable HCC and PVTT treated with SBRT. WJH [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 27, 2025 Volume 17 Issue 12 Khosla D et al. SBRT for unresectable HCC with PVTT METHODS This retrospective, single-institution study included adult HCC patients with PVTT treated between March 2020 and December 2023. Eligibility criteria included Child-Pugh A-B liver function, serum bilirubin < 3 mg/dL, Eastern Co-operative Oncology Group performance status 0-2, a normal liver volume > 700 cc, and a tumor-lumen distance> 5 mm. SBRT dose and fractionation were determined based on tumor volume and organ-at-risk constraints. Baseline clinical and dosimetric parameters were recorded. Survival analysis was performed using Kaplan-Meier curves, response was assessed at 3 months post-SBRT using the Revised Response Evaluation Criteria in Solid Tumors 1.1 criteria, and toxicity was graded per Common Terminology Criteria for Adverse Events 4.0. RESULTS Thirty patients (median age: 65 years, 9

FAQs

What was the purpose of this retrospective SBRT study in unresectable HCC with PVTT?

The study aimed to describe clinical characteristics and early outcomes of patients with unresectable HCC and portal venous tumor thrombosis treated with SBRT.

Who was eligible for SBRT in this study?

Eligible patients were adults with HCC and PVTT treated between March 2020 and December 2023, with Child-Pugh A-B liver function, bilirubin < 3 mg/dL, ECOG 0-2, normal liver volume > 700 cc, and tumor-lumen distance > 5 mm.

What treatment response and survival outcomes were reported?

The overall response rate was 83.3%, with median overall survival of 13 months and progression-free survival of 10.2 months. No grade 4 toxicities were observed.

Sep 28, 2026

Uploaded by Mary Man