Fallbericht zur neoadjuvanten hyperfraktioniert-akzelerierten Strahlentherapie eines hepatozellulären Karzinoms (HCC)

Abstract

Hepatocellular carcinomas are among the most frequent solid tumour entities worldwide. Because of the advanced tumour stage frequently observed at diagnosis a tumour resection as a curative treatment option is often impossible. Therefore the consideration of alternative treatment methods (possibly enhancing the chance of a subsequent tumour resection) and the improvement of existing palliative treatment options are gaining considerable importance. A 77-years-old female patient was diagnosed to have a rapidly progredient expansion in the liver in August 2003. Due to its large extension a local tumour resection was impossible and therefore a hyperfractionated accelerated radiotherapy up to a total dose of 55.0 Gy (single dose 1.2 Gy / 1.3 Gy 2 daily fractions, 12 fractions per week, overall treatment time: 27 days) was applied to both well-definable expansions (segments IV and V) from September to October 2003. Despite the large target volume (about 50% of the total liver volume) at an extended HCC and considering the fact that initially symptomatic treatment was aimed at, a curative tumour resectability with subsequent R0 partial liver resection at an interval of 9 months could be achieved by means of radiotherapy treatment.