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Of the 103 patients who received EBRT, 32 (31.1%) showed complete disappearance of tumor thrombi, 25 (24.3%) were in partial remission, 40 (38.8%) were stable in their tumor thrombi, and 6 (5.8%) showed disease progression at the end of the study period. The median survival was 9.9 months, and the 1-year survival rate was 37.1% in the EBRT group. In the non-EBRT group, the median survival and 1-year survival rates were 4 months and 12.3%, respectively. In stepwise multivariate analysis, EBRT showed a strongly protective value (relative risk 0.381, p < 0.001). Survival was not related to intrahepatic tumor status in the non-EBRT patients. However, in the EBRT group, poorer prognosis was significantly related to intrahepatic multifocal or diffusion lesions. The survival experience in the patients with IVC tumor thrombi was significantly worse in the non-EBRT group, their median and 1 year survival were 2 months and 0%, respectively. Dramatically, IVC tumor thrombus reversed to be a protective factor in EBRT group, their median and 1 year survival were 12.3 months and 53.5%, respectively. The most common reason for death was liver failure caused by uncontrolled intrahepatic disease. The toxicity is mild, and none of these adverse effects the timing and delivery of EBRT.
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