ABSTRACT
Objective To compare the safety and efficacy of endovascular brachytherapy (EVBT)with those of sequential three-dimensional conformal radiotherapy (3-D CRT) in treating main portal vein tumor thrombus (MPVTT).Methods The clinical data of a total of 176 hepatocellular carcinoma (HCC)patients complicated by MPVTT,who were treated with portal vein stenting and TACE during the period from May 2012 to June 2014,were retrospectively analyzed.Of the 176 patients,additional EVBT by using 125I seeds strand was carried out in 123 patients (group A) at the same time,and in the remaining 53 patients (group B) sequential 3-D CRT was conducted.The overall survival,progression free survival,stent patency period and the incidence of treatment-related complications were compared between the two groups.Results No serious treatment-related complications occurred after therapy.During a mean of (11.7±8.3) months followup period,the mean survival was (11.7±1.2) months in group A and (9.5±1.8) months in group B (P=0.002).The mean progression free survival in group A and in group B was (5.3±0.7) months and (4.4±0.4)months respectively (P=0.010).The mean stent patency period in group A and in group B was (10.3±1.1)months and (8.7±0.7) months respectively (P=0.003).Conclusion Compared to sequential 3-D CRT,EVBT combined with portal vein stenting and TACE can significantly improve the overall survival of patients with HCC complicated by MPVTT.