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J Liver Cancer > Volume 13(2); 2013 > Article
Journal of the Korean Liver Cancer Study 2013;13(2):178-184.
DOI: https://doi.org/10.17998/jlc.13.2.178    Published online September 30, 2013.
A Case of Hypovascular Hepatocellular Carcinoma Invading Bile Duct with Partial Remission with Combination Therapy of Transarterial Chemoembolization and Stereotactic Body Radiation Therapy and Sorafenib
Sang Youn Hwang1, Seon-Mi Lee1, Jung Woo Im1, Joon Suk Kim1, Sang Bu Ahn2, Eun Kyeong Ji2, Chul Won Choi3, Gwang-Mo Yang3
1Departments of Internal Medicine and Gastrointestinal Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
2Departments of Radiology, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
3Departments of Radiation Oncology, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
Correspondence:  Sang Youn Hwang,
Email: mongmani@daum.net
Copyright ©2013 by The Korean Liver Cancer Association
Abstract
Hepatocellular carcinoma (HCC) patients with bile duct invasion have a poor prognosis because many do not receive effective treatment. Surgical resection is thought to be only option of curative treatment, increasing chance of survival, but it is possible to minor group of patients because of poor reserved liver function associated with underlying liver disease and obstructive jaundice. Therefore many clinicians or centers still select locoregional therapy such as transarterial chemoembolization (TACE), radiation therapy (RT) etc. Stereotactic body radiation therapy (SBRT) is new technology providing very highly conformal ablative radiation dose for a small numbers (1-5 fractions) of large fraction size and is expected to salvage modality for HCC showed incomplete response of TACE due to vascularity or accessibility of feeding artery. Based on above suggestions, we herein offer our experience of a patient with partial remission of tumor by combination therapy of TACE, SBRT and sorafenib. Further study, maybe regarding a combination of locoregional and systemic therapy (so called multidisciplinary approach), is necessary on how to manage HCC patients with bile duct invasion or sparse vascularity.
Key Words: Hypovascular hepatocellular carcinoma; Bile duct invasion; Trasnarterial chemoembolization; Stereotactic body radiation therapy
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