LETTER Safety and efficacy of TACE

Abstract

and gamma knife on hepatocellular carcinoma with portal vein invasion We read with interest the article by Bruix et al1 in which Sorafenib was regarded as the standard treatment for hepatocellular carcinoma (HCC) patients with portal vein tumour thrombosis (PVTT). However, Sorafenib can only confer 2–3 months of overall survival (OS) benefit2 3 and is inapplicable to many patients due to exten-sive side effects and high price. Zhong et al4 proposed that liver resection might provide survival benefit to patients with HCC-PVTT with adequate liver function. However, this proposal was based on lit-erature survey, lacked definite patient inclusion criteria and failed to provide information on patients ’ baseline characteristics. Therefore, explorations of alternative therapeutics for patients with HCC-PVTTare still needed. Although not recommended by main-stream guidelines5 6 for patients with HCC-PVTT, transarterial chemoembolisa-tion (TACE) has long been practiced in the clinic in selected patients with HCC-PVTT.7 8 Gamma knife surgery (GKS) has shown favourable effects in treat-ing brain metastases of HCC.9 However, its application in the treatment of HCC-derived PVTT has not been reported, although it has been practiced in China for several years. Herein, we retrospectively analyse the safety and efficacy of TACE alone or in combination with GKS in treat-ing patients with HCC-PVTT. Institutional Ethics Committee approved the retrospective analyses of consecutive patients with HCC with PVTT admitted to Changhai Hospital