- A Case of Combination Therapy Using Radioembolization and Transarterial Chemoembolization with Drug-eluting Beads in Bilobar Hepatocellular Carcinomas
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Hee Yeon Kim, Chung-Hwa Park, Do Seon Song, Myeong Jun Song, Jong Young Choi, Seung Kew Yoon, Si Hyun Bae, Ho Jung Chun
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Journal of the Korean Liver Cancer Study Group. 2012;12(2):128-132. Published online September 30, 2012
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Abstract
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- Bilobar multifocal hepatocellular carcinomas (HCCs) can be treated with transarterial radioembolization in a sequential lobar, or whole liver manner. However, radioembolization could result in a risk of radiation-induced liver toxicity in patients with reduced functional reserve. Here we describe a case with bilobar HCCs successfully treated with a combination therapy using radioembolization and transarterial chemoembolization with drug-eluting beads without significant side effects. A 72-year-old female with liver cirrhosis was diagnosed of hepatocellular carcinoma with bilobar involvement. The main mass in the left lobe was treated with radioembolization while the other lesion in the right lobe was treated with transarterial chemoembolization using drug-eluting beads, and the patient was tolerable. A combination of radioembolization and selective transarterial chemoem- bolization may be considered for an alternative option in patients with bilobar multifocal HCCs with decreased liver function.
- A Case of Hepatocellular Carcinoma in a 10 Year Old Child Treated with Yttrium Radioembolization and Transarterial Chemoembolization
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Sung Won Lee, Hee Yeon Kim, Do Seon Song, Chung-Hwa Park, Myeong Jun Song, Jong Young Choi, Seung Kew Yoon, Jung Suk Oh, Ho Jong Chun, Si Hyun Bae
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Journal of the Korean Liver Cancer Study Group. 2012;12(2):137-140. Published online September 30, 2012
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Abstract
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- Hepatocellular carcinoma (HCC) in childhood is rare but is the second most common malignant liver neoplasm after
hepatoblastoma in children. Surgical resectability is the foundation of curative therapy but only one third of newly diagnosed
HCCs are resectable, and unresectable HCC remains largely unresponsive to systemic chemotherapy. In all reported series of
HCC in children, therapeutic results are poor with overall survival less than 30%. Systemic chemotherapy is only partially
effective but if preoperative downstaging can be achieved, it would result in a higher survival rate. There are scarce data
regarding local ablative treatments such as transarterial chemoembolization (TACE) and therefore survival benefits are still
unclear. TACE may be considered as a therapeutic alternative in cases of unresectable tumors after systemic chemotherapy or in
unresectable, non-metastatic HCCs. The use of orthotopic liver transplantation in childhood HCC remains controversial.
Radioembolization is a mode of treatment that aims to selectively target radiation to all liver tumors using yttrium-90
microspheres while limiting the dose to normal liver parenchyma. It may be considered as another treatment option in childhood
HCC with the purpose of preoperative downstaging but further studies are required to determine the treatment benefits and safety
of radioembolization treatment.
- A Case of Progressive Superior Mesenteric Vein Thrombosis after Percutaneous Transhepatic Obliteration in Infiltrative Hepatocellular Carcinomaswith Portal Vein Thrombosis
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Hee Yeon Kim, Chung-Hwa Park, Sung won Lee, Do Seon Song, Myeong Jun Song, Jong Young Choi, Seung Kew Yoon, Si Hyun Bae, Jung Suk Oh, Ho Jong Chun
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Journal of the Korean Liver Cancer Study Group. 2012;12(2):146-150. Published online September 30, 2012
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- Percutaneous transhepatic obliteration of gastroesophageal varices is one of the effective emergency procedure when
endoscopic therapy is not indicated or has been failed. One of the major complications of this procedure is portal thrombosis. A
53-year-old male with hepatitis B virus infection was diagnosed of infiltrative hepatocellular carcinoma with right portal vein
thrombosis. On the next day after being hospitalization, the patient developed variceal bleeding. With medical management,
endoscopic therapy was initially attempted, however, it ended in failure. Emergency percutaneous transhepatic obliteration of
bleeding gastroesophageal varices was considered as a next option. Bleeding from gastroesophageal varices was stopped after
percutaneous obliateration, however, portal thrombosis was extended to splenic vein or superior mesenteric veins.
- From Down Staging to Curative Treatment: Based on Hepatic Arterial Infusion Chemotherapy in a Hepatocellular Carcinoma Patient
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Chung-Hwa Park, Myung Joon Song, Seung Kew Yoon, Jong Young Choi, Si Hyun Bae
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Journal of the Korean Liver Cancer Study Group. 2011;11(1):46-49. Published online February 28, 2011
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Abstract
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- Hepatic arterial infusion chemotherapy (HAIC) is performed in patients with advanced hepatocellular carcinoma (HCC) in
which locoregional therapeutic methods such as transarterial chemoembolization (TACE), percutaneous ethanol injection (PEI)
or radiofrequency ablation (RFA) could not be the best choice. Sorafenib, the only approved systemic chemotherapeutic agent
for HCC, improves survival rate, but is associated with a low tumor response rate. Thus combining these therapeutic modalities to
treat HCC in advanced stage may help downstaging and leading to better treatment results without taking risk for hepatic failure.
Here we report a case treated to a complete remission by combining HAIC, PEI and sorafenib.
- A Case of Complete Remission in Hepatocellular Carcinoma by Metronomic Hepatic Artery Infusion Chemotherapy
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Myeong Jon Song, CHung-Hwa Park, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Ho Jong Chun
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Journal of the Korean Liver Cancer Study Group. 2010;10(1):35-39. Published online June 30, 2010
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- A 53-year-old man patient was admitted for evaluation of abdominal pain. Liver dynamic CT showed infiltrative type mass
in right hepatic angle with arterial enhancement and rapid washout. Also low density tumor thrombus is filled with in right
portal vein. He was diagnosed HCC (UICC stage IVa) with liver cirrhosis (Child-Pugh class B). With the sixth cycle of metronomic
hepatic artery infusion chemotherapy for infiltrative mass, HCC showed no stain in hepatic angiography and tumor marker
are normalized at seven month from initial diagnosis.
- Hepatocellular Carcinoma Diagnosed with Metastatic Lesion of the Cervical Spine
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Chung-Hwa Park, Myeong Jun Song, Hee Yeon Kim, Si Hyun Bae, Seung Kew Yoon, Jong Young Choi
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Journal of the Korean Liver Cancer Study Group. 2010;10(1):61-63. Published online June 30, 2010
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- Bone metastases in hepatocellular carcinoma (HCC) are usually treated with non-operative procedures such as radiotherapy,
hormonal therapy, bisphosphonates, or sometimes with surgical procedures. Here we describe a case with 3rd cervical spine
metastasis of HCC. A 62-year-old female with liver cirrhosis presented with neck pain. After evaluation, the patient was
diagnosed of hepatocellular carcinoma with cervical spine metastasis. The metastatic lesion was treated with tomotherapy
while the primary lesion in the liver was treated with transarterial chemoembolization using drug-eluting beads, and the
patient is tolerable waiting for the next treatment.
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