Combined Transarterial Chemoembolization and External Beam Radiotherapy in a Patient with Recurrent Huge Hepatocellular Carcinoma after Hepatic Resection.

Jesang Yu, Jinhong Jung, Sang Min Yoon
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Abstract

The optimal treatment strategy for unresectable huge hepatocellular carcinoma (HCC) is yet to be established. Non-surgical monotherapy demonstrated insufficient oncologic outcomes in previously reported studies. To improve the clinical outcomes of unresectable huge HCC, combined locoregional treatments can be considered in selected cases. Here, we report a case of 58-year-old male patient who was treated with combined transarterial chemoembolization (TACE) and external beam radiotherapy for recurrent HCC after a previous hepatic resection. After combined TACE and radiotherapy for the intrahepatic lesion, two metastases were diagnosed in the pelvic bones and lung; each lesion was successfully treated with salvage radiotherapy. During the long-term follow-up period (around 8 years 7 months after combined TACE and radiotherapy for the recurrent huge HCC), no definite viable tumors were observed in any of the treated liver, bone, and lung lesions.

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经动脉化疗栓塞联合外束放疗治疗肝切除术后复发大肝癌1例。
不可切除的巨大肝细胞癌(HCC)的最佳治疗策略尚未确定。在先前报道的研究中,非手术单药治疗显示肿瘤预后不足。为了改善不可切除的巨大HCC的临床疗效,可在选定的病例中考虑局部联合治疗。在这里,我们报告了一例58岁的男性患者,他在先前的肝切除术后接受了联合经动脉化疗栓塞(TACE)和外束放疗治疗复发性HCC。肝内病变经TACE联合放疗后,盆腔骨及肺转移2例;所有病变均成功接受补救性放射治疗。在长期随访期间(TACE联合放疗治疗复发性巨大HCC后约8年7个月),治疗的肝、骨、肺病变均未见明确的存活肿瘤。
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Transarterial chemoembolization for hepatocellular carcinoma: 2023 expert consensus-based practical recommendations of the Korean Liver Cancer Association. Implications of the first edition of the Korean expert consensus-based practice recommendations for transarterial chemoembolization in the management of hepatocellular carcinoma. Nomogram for predicting overall survival in patients with large (>5 cm) hepatocellular carcinoma based on real-world practice. Letter regarding "Feasibility of additional radiotherapy in patients with advanced hepatocellular carcinoma treated with atezolizumab plus bevacizumab". A single hepatic mass with two tales: hepatic tuberculosis and hepatocellular carcinoma.
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