- A Case of Achieving Complete Remission with Combination of Stereotactic Body Radiation Therapy and Transarterial Chemoemoblization in Patients with 4.8 cm Sized Infiltrative Hepatocellular Carcinoma with Arteriovenous Shunt
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Sang Youn Hwang, Seon-Mi Lee, Jung Woo Im, Joon Suk Kim, Ki Jeong Jeon, Sang Bu Ahn, Eun Kyeong Ji, Hyun-Cheol Kang, Cheol-Won Chol, Gwang-Mo Yang
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J Liver Cancer. 2015;15(1):64-69. Published online March 31, 2015
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DOI: https://doi.org/10.17998/jlc.15.1.64
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Abstract
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- Infiltrative hepatocellular carcinoma (HCC) patients have a poor prognosis because most
patients present with advanced disease. Although tumor size is small, ablation therapy
is difficult because it is difficult to delineate tumor boundary and tumor often combined
vascular invasion. Therefore many clinicians still try locoregional therapy (LRT) such as
transarterial chemoembolization (TACE), radiation therapy (RT), or combination with LRT
and sorafenib in this situation. Stereotactic body radiation therapy (SBRT) is new technology
providing very highly conformal ablative radiation dose and is expected to salvage modality
for HCC showed incomplete response of TACE due to combined arteriovenous (AV) shunts.
Based on above suggestions, we herein offer our experience of a complete remission of tumor
by combination of SBRT and TACE in a patient with infiltrative HCC. Further study, maybe
regarding a combination of locoregional and systemic therapy is necessary on how to manage
infiltrative HCC with AV shunts.
- A Case of Achieving Partial Remission with Combination of Radiation Therapy and Sorafenib inChild-Pugh Class B Patients with Hepatocellular Carcinoma with Main Portal Vein Invasion and Lymph Node Metastasis
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Sang Youn Hwang, Seon-Mi Lee, Jung Woo Im, Joon Suk Kim, Sang Bu Ahn, Eun Kyeong Ji, Hyun-Cheol Kang, Cheol-Won Choi, Gwang-Mo Yang
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J Liver Cancer. 2014;14(2):120-126. Published online September 30, 2014
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DOI: https://doi.org/10.17998/jlc.14.2.120
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Abstract
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- Reserved liver function is one of the most important determinants of survivial in advanced
hepatocellular carcinoma (HCC). Especially in cirrhotic patient with decompensated liver
function, sorafenib for HCC with main portal vein invasion have limited efficacy and survival
benefit. Therefore many clinicians or centers still try locoregional therapy (LRT) such as
transarterial chemoembolization (TACE), radiation therapy (RT), or combination with LRT
and sorafenib in this situation. However this multidisciplinary approach may increase
treatment related toxicity such as liver failure, etc. Recently, studies for combination of RT
and sorafenib for HCC with portal vein invasion have been tried and reported not only better
therapeutic efficacy, but also more hepatic toxicity.Based on above suggestions, we herein
offer our experience of a patient that although achieved survival gain via partial remission
of intrahepatic tumor and main portal vein thrombosis and metastatic lymph node by
combination therapy of RT and sorafenib, finally expired due to hepatictoxicity. Further study,
maybe regarding a combination of locoregional and systemic therapy, is necessary on how to
manage decompenstated cirrhotic patients with HCC with main portal vein invasion. (J Liver
Cancer 2014;14:120-126)
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