Changes in Arterioportal Shunts in Hepatocellular Carcinoma Patients with Portal Vein Thrombosis Who Were Treated with Chemoembolization Followed by Radiotherapy

다국어 초록 (Multilingual Abstract)

Purpose In this study, we retrospectively investigated the prevalence of arterioportal (AP) shunts inhepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) andevaluated the changes in AP shunts after chemoembolization followed by external beamradiation therapy (EBRT).

Materials and MethodsWe analyzed 54 HCC patients with PVTT who were treated with chemoembolization followedby EBRT. EBRT was uniformly delivered at a total dose of 30 to 45 Gy (median, 35 Gy), witha daily dose of 2 to 4.5 Gy. Angiographic images of chemoembolization before and afterradiation therapy (RT) were reviewed to investigate the AP shunt.

ResultsDuring the initial session of chemoembolization, 33 of 54 patients (61%) had an AP shunt.

After EBRT, 32 out of 33 patients had an additional session of chemoembolization and wereevaluated for a change in the AP shunt. The AP shunt decreased in 20 of 32 patients (63%)after chemoembolization followed by EBRT. The 1-year calculated overall survival (OS) ratefor all patients was 52.6% and the 2-year OS was 36.4%. The median OS in all patients was13 months. Patients with AP shunt showed poorer median OS than those without AP shunt,but there was no statistically significant difference (median, 12 months vs. 17 months).

ConclusionThe AP shunt frequently occurs in HCC patients with PVTT. This study suggests that a poorprognosis is associated with an AP shunt. Chemoembolization followed by RT may producea decrease in AP shunts.

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