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Stereotactic Ablative Radiotherapy for Hepatocellular Carcinoma With Major Portal Vein Invasion

Phase 2
Completed
Conditions
Hepatocellular Carcinoma
Portal Vein Tumor Thrombus
Interventions
Radiation: Stereotactic ablative radiotherapy
Registration Number
NCT01850368
Lead Sponsor
Korea Cancer Center Hospital
Brief Summary

Recently, several studies reported promising outcomes of patients after external beam radiotherapy (EBRT) for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis. However, conventional EBRT is composed of many fractions (20-35 fractions). On the other hand, stereotactic ablative radiotherapy is a newly emerging treatment method to deliver a high dose of radiation to the target using a few fractions with a high precision within body. SABR increases radiation biologic effect for tumor, makes patients more comfortable due to reduction of the number of hospital visit, and enables patients to receive another treatment more quickly. This study will evaluate SABR effect with 40 Gy in 4 fractions for HCC with major portal vein tumor thrombosis.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
35
Inclusion Criteria
  • Male or female patients ≥ 20 years of age
  • Initially diagnosed or recurrent hepatocellular carcinoma (HCC)
  • Eastern Cooperative Oncology Group performance status 0 or 1
  • HCC with major portal vein tumor thrombosis (tumor thrombosis in the main portal vein or 1st branch of portal vein)
  • Cirrhotic status of Child Pugh class A or B7
  • Patients can have extra-hepatic disease; provided the hepatic disease is the highest burden, the extra-hepatic disease is low burden and potentially treatable with radiotherapy, chemotherapy and target agent etc; patient survival is expected to be at least 6 months.
  • Patient or guardian must be able to provide verbal and written informed consent
Exclusion Criteria
  • Prior trans-arterial chemo-embolization ≥4 after diagnosis of major portal vein tumor thrombosis
  • Severe complication caused by liver cirrhosis eg. variceal bleeding, poorly controlled ascites, hepatic encephalopathy)
  • Uncontrolled inter-current illness except liver cirrhosis

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Stereotactic ablative radiotherapyStereotactic ablative radiotherapyStereotactic ablative radiotherapy for HCC patients with major portal vein tumor thrombosis (tumor thrombosis in the main portal vein or 1st branch of portal vein)
Primary Outcome Measures
NameTimeMethod
Tumor stabilization rate2 months

Tumor stabilization rate was based on the combined number of patients with complete response(CR), partial response(PR), and stable disease(SD) by modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria.

Secondary Outcome Measures
NameTimeMethod
Overall survival6 months, 1 year and 2 year

From the date of SABR to the date of death or last follow-up

Tumor progression free survival6 months, 1 year and 2 year

From the date of SABR to the date of first failure or last follow-up

Treatment related toxicity1 year

Adverse events using Common Terminology Criteria for Adverse Events (CTCAE) version 4.0; Classic radiation induced liver disease; Non-classic Classic radiation induced liver disease; Worsening of Child-Turcotte-Pugh score; Worsening of MELD score

Trial Locations

Locations (8)

Keimyung University Dongsan Medical Center

🇰🇷

Daegu, Korea, Republic of

Soon Chun Hyang University Hospital Seoul

🇰🇷

Seoul, Korea, Republic of

Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences

🇰🇷

Seoul, Korea, Republic of

Gyeongsang National University Hospital

🇰🇷

Jinju, Gyeongsang-nam-do, Korea, Republic of

Inha University Hospital

🇰🇷

Incheon, Korea, Republic of

Dongnam Institute of Radiological & Medical Sciences

🇰🇷

Busan, Korea, Republic of

Catholic University Incheon St. Mary's Hospital

🇰🇷

Incheon, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

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