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JLC : Journal of Liver Cancer

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2 "Combination therapy"
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Case Reports
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
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
J Liver Cancer. 2014;14(2):120-126.   Published online September 30, 2014
DOI: https://doi.org/10.17998/jlc.14.2.120
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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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A Case of Early Hepatocellular Carcinoma Treatment Combined by Transarterial Chemoembolization and Radiofrequency Ablation
Jun Uk Lim, Hyun Phiil Shin, Joung Il Lee, Jae Jun Park, Jung Won Jeon, Kyuseong Lim
Journal of the Korean Liver Cancer Study Group. 2012;12(1):32-36.   Published online February 28, 2012
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In most early hepatocellular carcinoma (HCC), surgical resection or liver transplantation is the first choice of treatment. However, surgery is often impossible because of patient’s physical condition such as advanced liver cirrhosis, other comorbidities, and radiofrequency ablation (RFA) can be used as substitute treatment. Recently, it has been reported that clinical outcomes of transarterial chemoembolization (TACE) combined with RFA were similar to that of surgical resection. This report describes a 49-year-old male with 1.5 cm sized HCC. Because the patient could not undergo surgical resection and the tumor was not localized on ultrasonography (US), TACE was performed instead. But the residual tumor was still detected on follow-up contrast enhanced US, we performed additional RFA. After combined treatment with TACE and RFA, viable portion of the tumor was not detected on one month follow-up CT and MRI image. The patient remains well without recurrence, 12 months after combined treatment. It is suggested that TACE combined with RFA can be an alternative choice of early small HCC treatment.
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JLC : Journal of Liver Cancer