- A Case of Stereotactic Body Radiation Therapy (SBRT) for HCC
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Jang Won Park, Gang Mo Kim
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Journal of the Korean Liver Cancer Study Group. 2013;13(1):80-84. Published online February 28, 2013
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DOI: https://doi.org/10.17998/jlc.13.1.80
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Abstract
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- RT is an effective local therapy that has the potential to benefit patients unsuitable for and/or at high risk of complication
following standard local-regional therapies. All of the following have facilitated the safe delivery of tumorcidal doses to focal
HCCs using conformal RT: advances in imaging, RT planning techniques, image-guided radiotherapy, tumor immobilization,
and improved knowledge of what volume of liver is required to be spared from radiation to preserve function. SBRT has more
recently been used to treat focal HCC. SBRT is widely available and more convenient for patients than conventionally
fractionated RT, as it is delivered in far fewer fractions than standard fractionated RT. We report our experience for a patient
treated successfully with SBRT.
- A Case of Atypicial Finding on Follow-up CT after TACE with Doxorubicin-eluting-beads (DEB)
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Jang Won Park, Gang Mo Kim
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Journal of the Korean Liver Cancer Study Group. 2012;12(2):164-168. Published online September 30, 2012
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Abstract
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- Hepatocellular carcinoma is the sixth most common cancer and the third leading cause of cancer-ralated death. TACE is an
effective option for patients with intermediate HCC. Although conventional TACE with administration of a Lipiodo-anticancer
emulsion followed by embolic agents has been most popular technique, the recent introduction of embolic DEB has provided a
valuable alternative. The DEB is a novel drug delivery embolization system that hea been designed to deliver a higher and more
sustained release of drug directly into the tumor and a low release of drug into the systemic circulation, with the intention to
maximize the drug effectiveness in terms of response, while significantly reducing its systemic toxicity. Obtaining a triple-phase
CT or MRI imaging of the liver is required to integrate clinical and laboratory data to evaluate the indication to TACE with DEB
and additional imaging to exclude extrahepatic disease should be performed as pretreatment imaging. Obtaining a CT or MRI
imaging 2-4 weeks after TACE is recommend to assess tumor response and to decide the further plan. The use of modified
Response Evaluation Criteria in Solid Tumors (mRECIST) for HCC is recommended for response Classification. We offer our
experience of a patient with atypical finindg on follow-up CT after DEB TACE. Marginal recurrence or residual viable tumor
was suspected on CT 4 weeks after DEB TACE but disappeared on CT 10 weeks after treatment. There was no evidence of
recurrence or residual tumor in TACE site and its margin 12 weeks after TACE. We thought that it was attributed to the benign
change as AV shunt or to the characteristics of DEB which has been designed to deliver slowly, higher and more sustained release
of drug directly into the tumor. But further study is necessary on how long the drug delivery from DEB to tumor is sustained and
when the appropriate tumor response is accomplished after treatment.
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