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KMID : 0964020130130020178
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Journal of the Korean Liver Cancer Study Group
2013 Volume.13 No. 2 p.178 ~ p.184
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A Case of Hypovascular Hepatocellular Carcinoma Invading Bile Duct with Partial Remission with Combination Therapy of Transarterial Chemoembolization and Stereotactic Body Radiation Therapy and Sorafenib
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Hwang Sang-Youn
Lee Seon-Mi
Im Jung-Woo
Kim Joon-Suk
Ahn Sang-Bu
Ji Eun-Kyeong
Choi Chul-Won
Yang Kwang-Mo
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Abstract
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Hepatocellular carcinoma (HCC) patients with bile duct invasion have a poor prognosis because many do not receive effective treatment. Surgical resection is thought to be only option of curative treatment, increasing chance of survival, but it is possible to minor group of patients because of poor reserved liver function associated with underlying liver disease and obstructive jaundice. Therefore many clinicians or centers still select locoregional therapy such as transarterial chemoembolization (TACE), radiation therapy (RT) etc. Stereotactic body radiation therapy (SBRT) is new technology providing very highly conformal ablative radiation dose for a small numbers (1-5 fractions) of large fraction size and is expected to salvage modality for HCC showed incomplete response of TACE due to vascularity or accessibility of feeding artery. Based on above suggestions, we herein offer our experience of a patient with partial remission of tumor by combination therapy of TACE, SBRT and sorafenib. Further study, maybe regarding a combination of locoregional and systemic therapy (so called multidisciplinary approach), is necessary on how to manage HCC patients with bile duct invasion or sparse vascularity.
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KEYWORD
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Hypovascular hepatocellular carcinoma, Bile duct invasion, Trasnarterial chemoembolization, Stereotactic body radiation therapy
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