Zhang ZH, et al. - The safety and efficacy of combined endovascular brachytherapy (EVBT), transarterial chemoembolization (TACE), and sorafenib to treat hepatocellular carcinoma (HCC) patients with main portal vein tumor thrombus (MPVTT) were assessed in this study. For MPVTT, EVBT combined with stent placement, TACE, and sorafenib could be a safe and effective palliative treatment option.

Methods

• The researchers performed this single-center retrospective study.
• They included 68 patients with unresectable HCC or those who were unfit for liver transplantation and percutaneous frequency ablation according to the BCLC classification.
• For this study, all patients had Child-Pugh classification grade A or B, Eastern Cooperative Oncology Group (ECOG) performance status of 0-2, and MPVTT.
• The patients received either EVBT with stent placement, TACE, and sorafenib (group A, n = 37), or TACE with sorafenib (group B, n = 31).
• They evaluated the time to progression (TTP) and overall survival (OS) by propensity score analysis.

Results

• In group A, the 6-, 12-, and 24-mo survival rates were 88.9%, 54.3%, and 14.1%, and in group B, the respective survival rates were 45.8%, 0%, and 0%, respectively (P < 0.001), in the entire cohort.
• In group A, the median TTP and OS were significantly longer than group B (TTP: 9.0 mo vs 3.4 mo, P < 0.001; OS: 12.3 mo vs 5.2 mo, P < 0.001).
• The median OS was longer in group A than in group B (10.3 mo vs 6.0 mo, P < 0.001) in the propensity score-matched cohort.
• Likewise, in group A, the median TTP was longer than in group B (9.0 mo vs 3.4 mo, P < 0.001).
• The researchers showed that the EVBT combined with stent placement, TACE, and sorafenib strategy was an independent predictor of favorable OS (HR = 0.18, P < 0.001) in multivariate Cox analysis.