Advanced Stage Hepatocellular Carcinoma Successfully Treated with Transarterial Radioembolization and Multi-tyrosine Kinase Inhibitor Therapy.

Myung Ji Goh, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik
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Abstract

Transarterial radioembolization (TARE) with yttrium-90 microspheres has become widely utilized in managing hepatocellular carcinoma (HCC). The utility of TARE is expanding with new insights through experiences from real-world practice and clinical trials, and recently published data suggest that TARE in combination with sorafenib may improve the overall survival in selected patients. Here, we report a case of advanced stage HCC that was successfully treated with TARE and sorafenib. The patient achieved complete response (CR) at 12 months after the initial treatment with TARE and sorafenib, followed by additional transarterial chemoembolization and proton beam therapy for local tumor recurrence at 19-month post-TARE. The patient was followed up every 3 months thereafter and still achieved CR both biochemically and radiologically for the following 12 months. A combination strategy of TARE and systemic therapy may be a useful alternative treatment option for selected patients with advanced stage HCC.

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经动脉放射栓塞和多种酪氨酸激酶抑制剂治疗晚期肝细胞癌成功。
经动脉放射栓塞(TARE)与钇-90微球已被广泛应用于治疗肝细胞癌(HCC)。通过现实世界的实践和临床试验的经验,TARE的效用正在扩大,最近发表的数据表明,TARE联合索拉非尼可以提高选定患者的总生存率。在这里,我们报告了一例晚期HCC,成功地用TARE和索拉非尼治疗。患者在TARE和索拉非尼初始治疗后12个月达到完全缓解(CR),随后在TARE后19个月进行了额外的经动脉化疗栓塞和质子束治疗局部肿瘤复发。此后每3个月随访一次,在接下来的12个月里,患者在生化和放射学上都达到了CR。TARE和全身治疗的联合策略可能是晚期HCC患者的一种有用的替代治疗选择。
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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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