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Long-term complete response after transcatheter arterial 
chemoembolization and stereotactic body radiation therapy in 
a patient with hepatocellular carcinoma at the caudate lobe

Ann Hepatobiliary Pancreat Surg 2018 Aug;22(3):274-81
Published online August 31, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Yong-Kyu Chung1, Shin Hwang1, Gi-Young Ko2, Sang Min Yoon3

Departments of 1Surgery, 2Diagnostic Radiology, and 3Radiation Oncology, 
Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Received May 31, 2018; Revised June 1, 2018; Accepted June 29, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
It is expected that a combination of transcatheter arterial chemoembolization (TACE) with stereotactic body radiation therapy (SBRT) may induce synergistic therapeutic effects in hepatocellular carcinoma (HCC), which would result in a high rate of complete therapeutic response. In this study, we present the 5-year clinical course of a patient who had HCC at the caudate lobe, which was treated with TACE and SBRT. A 53-year-old male was diagnosed with an 8 cm-sized HCC at the caudate lobe with compression of the inferior vena cava (IVC). For fear of pulmonary metastasis, we decided to perform sequential TACE-radiotherapy instead of upfront hepatectomy, although the tumor appeared resectable. The first session of TACE, SBRT with 12 fractions, and the second session of TACE were sequentially performed. The patient was administered metformin for chemoprevention. Over the course of a 5-year follow-up, there was no evidence of HCC recurrence. We reported the clinical sequence of a patient showing complete therapeutic response of HCC at the caudate lobe after a combination of TACE and radiotherapy. This type of combined locoregional treatment can be a therapeutic option for HCC at the caudate lobe with marginal resectability.
Keywords : Treatment response; Recurrence; Radiotherapy

 

August 2018, 22 (3)