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Journal of the Korean Liver Cancer Study 2008;8(1):102-105.
Published online June 30, 2008.
A Case of Localized Concurrent Chemo-radiation Therapy Using with Tomotherapy for Hilar Hepatocellular Carcinoma with Invasion of Bilateral Bile Duct
Ki Tae Yoon1,3, Do Young Kim1,3, Jin Sil Seong2,3, Jun Yong Park1,3, Jong Won Choi1,3, Sang Hoon Ahn1,3, Kwang-Hyub Han1,3, Chae Yoon Chon1,3
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
2Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
3Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Correspondence:  Do Young Kim,
Email: dyk1025@yuhs.ac.kr
Copyright ©2008 by The Korean Liver Cancer Association
Hepatocellular carcinoma (HCC) usually takes an intrahepatic spread via portal vein branches, and the incidence of portal vein invasion is reported to be 34~40% in surgical resected series. On the other hand, the rate of intrabiliary growth of HCC is rare, ranging from 2.3~13% in surgical and autopsy cases. Here, we report a case of the patient treated with localized concurrent chemo-radiation therapy (CCRT) for hilar HCC with invasion of bilateral bile duct. The tomotherapy was performed with a total radiation dose of 4,240 cGy (20 times, 212 cGy/time) on tumor bed and hepatic arterial infusion of 5-fluorouracil (1,000 mg/day, day 1~5 and day 16~20) and cisplatin (60 mg/m2, day 3 and day 18) was done via implantable port system during the radiotherapy. After that, tumor size and tumor marker was decreased and treatment response was achieved as partial response. CCRT is expected as one of the appropriated treatment options for inoperable HCC with bile duct invasion.
Key Words: Hepatocellular carcinoma; Bile duct invasion; Localized concurrent chemo-radiation therapy


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