González T, Ocanto A. Is stereotactic body radiation therapy feasible in hepatocellular carcinoma with portal vein tumor thrombosis? World J Hepatol 2026; 18(9): 117761 [DOI: 10.4254/wjh.117761]
Corresponding Author of This Article
Abrahams Ocanto, MD, Department of Radiation Oncology, San Francisco de Asís University Hospital, Genesis Care, Calle Joaquín Costa 28, Madrid 28002, Spain. abraham.ocanto@gmail.com
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Oncology
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editorial
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González T, Ocanto A. Is stereotactic body radiation therapy feasible in hepatocellular carcinoma with portal vein tumor thrombosis? World J Hepatol 2026; 18(9): 117761 [DOI: 10.4254/wjh.117761]
World J Hepatol. Sep 27, 2026; 18(9): 117761 Published online Sep 27, 2026. doi: 10.4254/wjh.117761
Is stereotactic body radiation therapy feasible in hepatocellular carcinoma with portal vein tumor thrombosis?
Tomás González, Abrahams Ocanto
Tomás González, Department of Radiation Oncology, Cancer Center ABC, The American British Cowdray Medical Center, Mexico City 01120, Ciudad de Mexico, Mexico
Abrahams Ocanto, Department of Radiation Oncology, San Francisco de Asís University Hospital, Genesis Care, Madrid 28002, Spain
Author contributions: González T and Ocanto A designed the research study and performed the research; All authors read and approved the final version of the manuscript to be published.
AI contribution statement: AI tools, including ChatGPT (Open AI), were used in a limited capacity during the preparation in this manuscript to assist with language refinement and improve clarity and readability. No sections on the manuscript were generated by AI. All scientific content, including literature interpretation, critical analysis and conclusions, was developed by the authors. The manuscript was thoroughly reviewed and revised to ensure accuracy, originality and intellectually integrity. AI tools were not involved in the design of the study, data analysis, or interpretation of results. The authors take full responsibility for the content of this manuscript.
Conflict-of-interest statement: All authors declare no conflicts of interest in publishing the manuscript.
Corresponding author: Abrahams Ocanto, MD, Department of Radiation Oncology, San Francisco de Asís University Hospital, Genesis Care, Calle Joaquín Costa 28, Madrid 28002, Spain. abraham.ocanto@gmail.com
Received: December 15, 2025 Revised: December 30, 2025 Accepted: February 4, 2026 Published online: September 27, 2026 Processing time: 276 Days and 10.3 Hours
Abstract
Hepatocellular carcinoma (HCC) with portal venous tumor thrombosis (PVTT) carries a poor prognosis and limited therapeutic options. Khosla et al presented a retrospective study of 30 patients with unresectable HCC and predominantly advanced PVTT (VP3/VP4) treated with stereotactic body radiation therapy (SBRT) at 30-50 Gy in 5-6 fractions in World Journal of Hepatology. SBRT achieved an 83.3% response rate with a median overall survival of 13 months and acceptable toxicity, including no grade 4 events. These findings support SBRT as a safe and effective locoregional treatment for HCC with PVTT and highlight its potential role within multidisciplinary care.
Core Tip: Portal vein tumor thrombosis is a common and challenging presentation in hepatocellular carcinoma with significantly limited treatment options. This retrospective study highlighted the safety and efficacy of stereotactic body radiation therapy as a locoregional treatment in patients with unresectable hepatocellular carcinoma and portal vein tumor thrombosis. With an encouraging response rate of 83.3% and a median overall survival of 13 months, stereotactic body radiation therapy demonstrates promising early outcomes and minimal toxicity, supporting its role as a viable therapeutic option in this difficult-to-treat population.
