Journal of Clinical Oncology | 2019
External beam radiotherapy for hepatocellular carcinoma with right atrium tumor thrombus.
Abstract
328Background: Hepatocellular carcinoma (HCC) with right atrium tumor thrombus (RATT) via progression through hepatic veins into the inferior venal cava is a challenging entity with limited treatment options. Given the significant clinical sequelae of RATT, improved locoregional treatments are needed. We examined our experience with palliative right atrium-directed radiotherapy for HCC RATT. Methods: We conducted a retrospective study of 10 patients with HCC RATT treated with radiotherapy between 2011-2018. Patients with localized (n = 5) and metastatic (n = 5) disease were included. Clinical and treatment factors were collected. Results: Median follow-up was 3 mos. Baseline Childs Pugh score was A in 3 patients and B in 7 patients. The table below shows prescription and dosimetric data. No patients experienced grade ≥ 3 toxicity. The only major adverse cardiac event observed after radiotherapy was heart failure in 2 patients, and it was difficult to determine the contribution of treatment versus RATT. Th...