J Liver Cancer.  2021 Sep;21(2):163-168. 10.17998/jlc.2021.08.06.

Long-term survival after multimodal treatment involving radiotherapy for huge hepatocellular carcinoma with oligometastasis: a case report

• Lee BM
• Seong J

• KMID: 2520903
• DOI: http://doi.org/10.17998/jlc.2021.08.06

Abstract

The clinical efficacy of local ablative treatment for oligometastasis is widely accepted in most cancers. However, due to limited data, this has not been the case for hepatocellular carcinoma (HCC). Here, we report a case of pulmonary oligometastasis of a huge HCC that was treated by multimodality with liver-directed concurrent chemoradiotherapy (CCRT) plus subsequent resection of the primary lesion and local ablative radiotherapy (RT) for subsequent lung oligometastatic lesions. In this patient, liver-directed CCRT induced significant tumor shrinkage with compensatory hypertrophy of the non-tumor liver, followed by curative resection. Surgical resection of the first and second pulmonary metastatic lesions as well as local ablative RT of the third lesion achieved complete tumor regression, which led to long-term survival of 6 years. Therefore, the active use of local ablative RT requires full consideration in cases of oligometastatic HCC.

Keyword

Hepatocellular carcinoma; Metastasis; Radiotherapy; Combined modality therapy; Case report

Figure

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  Figure 1 Liver dynamic computed tomography (top) and magnetic resonance imaging (bottom) findings before versus after liver-directed concurrent chemoradiotherapy (CCRT).

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  Figure 2 Chest computed tomography images showing the first pulmonary metastatic lesions before and after systemic treatment.

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  Figure 3 Chest computed tomography images showing pulmonary metastatic lesions before versus after stereotactic body radiotherapy (SBRT).

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  Figure 4 Alpha-fetoprotein (AFP) and prothrombin induced by vitamin K absence-II (PIVKA-II) levels during follow-up. CCRT, concurrent chemoradiotherapy; SBRT, stereotactic body radiotherapy.

Reference

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