Abstract

Most patients with advanced hepatocellular carcinoma (HCC) are not suitable candidates for surgical treatment at the time of diagnosis because of poor liver function, extensive tumor involvement of the liver, vascular involvement, and/or intra/extrahepatic metastasis. We attempted localized concurrent chemo-radiation therapy (CCRT) followed by hepatic arterial infusion chemotherapy (HAIC) in patients having locally advanced HCC with vascular involvement and preserved hepatic function. We report a case of locally advanced HCC patient who became surgically resectable by downstaging after localized CCRT followed by HAIC. Localized CCRT was performed with a total radiation dose of 4,500 cGy (180 cGy × 25 times) and hepatic arterial infusion of 5-fluorouracil (5-FU, 500 mg/day) via implantable port system during the first and the last weeks of the radiotherapy. Following localized CCRT, the patient was scheduled to receive HAIC with 5-FU (500 mg/m2 for 5 hours, days 1～3) and cisplatin (60 mg/m2 for 2 hours, day 2) every 4 weeks. Marked contraction of HCC was noted on follow up computerized tomography (CT) and positron emission tomography (PET) after localized CCRT and HAIC, and subsequently surgical resection with curative aim was performed. The patient is in complete remission status without recurrence to date.

• Keywords: Hepatocellular carcinoma;Localized concurrent chemo-radiation therapy;Hepatic lobectomy