Retrospective two-center study of image-guided hypofractionated radiotherapy for hepatocellular carcinoma with portal vein thrombosis

External beam radiation therapy (RT) has shown promising effects for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). However, there is still a lack of consensus on the optimal RT scheme for PVTT treatment. A retrospective study at two centers in South Korea evaluated image-guided 10-fraction hypofractionated RT for these patients. At 3 months after RT, 13% had complete response, 36% had partial response, 46% had stable disease, and 4% had progressive disease. The median overall survival was 20.3 months, and 1-year freedom from local progression, progression-free survival, and overall survival rates were 89%, 27%, and 62%, respectively. Two patients (3%) had grade ≥ 3 toxicity. The authors conclude that hypofractionated RT demonstrated promising local PVTT control and OS rates with acceptable toxicity.