Journal of Liver Cancer

Case Report

Complete response to local therapy for advanced hepatocellular carcinoma with lung metastasis: a case report: Daeun Kim, Seiyeon Park, Won Sohn, Hyun Pyo Hong, Byung Ik Kim; J Liver Cancer. 2022;22(1):51-56. Published online January 27, 2022; DOI: https://doi.org/10.17998/jlc.2021.12.28

Abstract PDF: The concept of oligometastasis is widely accepted for various types of solid tumors; accordingly, better outcomes can be anticipated with aggressive local interventions. The treatment of advanced hepatocellular carcinoma (HCC) with extrahepatic metastasis is systemic therapy. However, treatment responses to systemic therapy are poor. Recently, a small number of metastatic cancers (oligometastasis) have been controlled by local therapy rather than systemic therapy. Our study reports a case of a 66-year-old male patient with advanced HCC with lung metastasis, which was treated with local therapy. There were less than four metastases in the lungs, which were treated with wedge resection, radiofrequency, and radiation therapy. He repeatedly underwent local therapy for lung oligometastasis and locoregional therapy for intrahepatic HCC rather than systemic therapy; control by local therapy was possible as his liver function was preserved with Child-Turcotte-Pugh class A.

Review Article

Clinical Experience of Tomotherapy in Oligometastasis and Metastatic Hepatocellular Carcinoma: Chul Seung Kay, Jee Yoon Kim, Jeong Won Jang; Journal of the Korean Liver Cancer Study Group. 2008;8(1):12-15. Published online June 30, 2008

Abstract PDF: Extracranialoligometastasis is most common in lung, liver and bone. The standard treatment is systemic chemotherapy but the value of chemotherapy is limited. So, we can suppose the beneficial effects from the addition of local therapy such as metastasectomy, cooling or heating method of tumor and radiotherapy. Stereotactic body radiotherapy is an alternative approach for surgically unresectable lesions because of proximity to blood vessels or other critical structures and multilobar involvement and for the medically inoperable patients or patients who do not require surgery. Extrahepatic metastasis from hepatocellular carcinoma has no general agreement on the optimal treatment strategy. Helical tomotherapy, a new type of dynamic radiotherapy, is an intensity modulated radiotherapy system equipped with megavoltage computed tomography image guidance. We can precisely deliver high dose of radiation to the tumor with maximal sparing of around normal tissue and simultaneously irradiate the multiple tumor using tomotherapy. We introduce the clinical experience of tomotherapy in oligometastasis and metastatic hepatocellular carcinoma for the last several years.

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