{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:16:26Z","timestamp":1778692586157,"version":"3.51.4"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T00:00:00Z","timestamp":1632355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In Thailand, individuals with hepatocellular carcinoma (HCC) who develop portal vein tumor thrombosis (PVTT) have a restricted treatment option because to the extent of the disease, poor underlying liver function, and non-coverage of immuno\/targeted therapy. Radiotherapy (RT) plays an increasingly important function in these patients. To investigate the feasibility, efficacy, and adverse event rates, we performed a retrospective analysis of patients with HCC with PVTT who underwent 3-dimensional conformal radiation (3DCRT), intensity-modulated radiation (IMRT), volumetric-modulated radiotherapy (VMAT), and stereotactic body radiotherapy (SBRT) in a single\u2014institution.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To examine clinical results in terms of overall survival (OS), local control (LC), response of primary tumor and PVTT, hepatic and gastrointestinal adverse reaction, and prognosis variables for OS and LC.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>Between July 2007 and August 2019, non-metastatic HCC with PVTT patients treated with RT were retrospectively reviewed and evaluated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>The analysis included data from 160 patients. The mean age of the patients was 60.8 years ((95% CI 58.2\u201362.0). The median diameter of the tumor was 7.7 cm (range: 1\u201324.5). 85 (54.5%) individuals had PVTT in the main or first branch. At 1.8\u201310 Gy per fraction, the mean biologically effective dose (BED) as \u03b1\/\u03b2 ratio of 10 was 49.6 (95% CI 46.7\u201352.5) Gy<jats:sub>10<\/jats:sub>. The median survival time was 8.3 (95% CI 6.1\u201310.3) months. Survival rates at one and two years were 39.6% and 17.1%, respectively. Estimated incidence of local failure using competing risk analysis were 24% and 60% at 1 and 2 years, respectively. The overall response rate was 74%, with an 18.5 percent complete response rate. In multivariate analysis, tumor size, overall response, and radiation dose were all significant prognostic variables for OS. Hepatic unfavorable events of grade 3 and 4 were for 14.1% of the total. There was no occurrences of grade 3\u20134 gastrointestinal toxicity, either acute or late. Additionally, there were no treatment-related mortality.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Advanced RT is regarded as a safe and effective therapeutic option for HCC with PVTT. Overall survival was clearly related to tumor size, radiation dose, and tumor\/PVTT response. Individuals with BED 56 Gy<jats:sub>10<\/jats:sub> had significantly better overall survival than patients with BED 56 Gy<jats:sub>10<\/jats:sub>. A prospective randomized trial is required to validate these outcomes in order to corroborate these findings.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0257556","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T22:46:04Z","timestamp":1632437164000},"page":"e0257556","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Advanced radiotherapy technique in hepatocellular carcinoma with portal vein thrombosis: Feasibility and clinical 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