Postoperative adjuvant IMRT for patients with HCC and portal vein tumor thrombus: An open-label randomized controlled trial

Aims: To investigate the impact of postoperative intensity modulated radiation therapy (IMRT) in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) after partial hepatectomy +/- thrombectomy. Methods: From July 2013 to June 2016, consecutive patients with HCC and PVTT who underwent partial hepatectomy were randomly assigned to 2 groups: a control group and an adjuvant IMRT group. Survival outcomes in the 2 groups were studied. Results: The 52 patients in this study were equally randomized into 2 groups with comparable clinicopathological data. The median disease-free survival (DFS) and overall survival (OS) were 9.1 +/- 1.6 months, 18.9 +/- 1.8 months for the adjuvant RT group and 4.1 +/- 0.5 months, 10.8 +/- 1.3 months for the control group, respectively. The 1-, 2- and 3-years overall survival rates were significantly better in the adjuvant IMRT group (76.9%, 19.2%, and 11.5%; respectively) than the control group (26.9%, 11.5% and 0%, respectively; p = 0.005). Conclusions: Postoperative IMRT significantly improved the overall survival outcomes in patients with HCC and PVTT after partial hepatectomy +/- thrombectomy. (C) 2019 Elsevier B.V. All rights reserved.