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JLC : Journal of Liver Cancer

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1 "Arteriovenous shunt"
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Case Report
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
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
J Liver Cancer. 2015;15(1):64-69.   Published online March 31, 2015
DOI: https://doi.org/10.17998/jlc.15.1.64
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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.
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