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J Liver Cancer > Volume 15(1); 2015 > Article
Journal of Liver Cancer 2015;15(1):64-69.
DOI: https://doi.org/10.17998/jlc.15.1.64    Published online March 31, 2015.
A Case of Achieving Complete Remission with Combination of Stereotactic Body Radiation Therapy and Transarterial Chemoemoblization in Patients with 4.8 cm Sized Infiltrative Hepatocellular Carcinoma with Arteriovenous Shunt
Sang Youn Hwang1, Seon-Mi Lee1, Jung Woo Im1, Joon Suk Kim1, Ki Jeong Jeon1, Sang Bu Ahn2, Eun Kyeong Ji2, Hyun-Cheol Kang3, Cheol-Won Chol3, Gwang-Mo Yang3
1Departments of Internal Medicine Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
2Departments of Radiology, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
3Departments of Radiation Oncology, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
Correspondence:  Sang Youn Hwang,
Email: mongmani@hanmail.net
Abstract
Infiltrative hepatocellular carcinoma (HCC) patients have a poor prognosis because most patients present with advanced disease. Although tumor size is small, ablation therapy is difficult because it is difficult to delineate tumor boundary and tumor often combined vascular invasion. Therefore many clinicians still try locoregional therapy (LRT) such as transarterial chemoembolization (TACE), radiation therapy (RT), or combination with LRT and sorafenib in this situation. Stereotactic body radiation therapy (SBRT) is new technology providing very highly conformal ablative radiation dose and is expected to salvage modality for HCC showed incomplete response of TACE due to combined arteriovenous (AV) shunts. Based on above suggestions, we herein offer our experience of a complete remission of tumor by combination of SBRT and TACE in a patient with infiltrative HCC. Further study, maybe regarding a combination of locoregional and systemic therapy is necessary on how to manage infiltrative HCC with AV shunts.
Key Words: Infiltrative hepatocellular carcinoma; Arteriovenous shunt; Stereotactic body radiation therapy; Transarterial chemoembolization
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