Abstract
Introduction. Transarterial chemoembolization is the first-line treatment in unresectable hepatocellular carcinoma. There is no standard treatment after transarterial chemoembolization failure. We report the case of a patient with advanced hepatocellular carcinoma who showed a complete response and a long cancer control with hypofractionated stereotactic radiotherapy after transarterial chemoembolization failure. Case Presentation. A 70-year-old Caucasian woman was treated with transarterial chemoembolization for advanced hepatocellular, but no cancer control was obtained. A hypofractionated stereotactic radiotherapy was planned delivering 40 Gy in 5 fractions. A dramatic reduction in alpha-fetoprotein was observed. Contrast-enhanced ultrasonography at 1 and 2 months showed large necrotic areas. Computerised tomography scan showed a 90% objective tumour response, then a complete remission at 3 and 6 months after treatment, respectively. Status of patient remained unchanged for 2 years. Conclusions. Hypofractionated stereotactic radiotherapy can improve survival and prognosis of unresectable hepatocellular carcinoma patient.
Highlights
Transarterial chemoembolization is the first-line treatment in unresectable hepatocellular carcinoma
We report the case of a patient with advanced hepatocellular carcinoma who showed a complete response and a long cancer control with hypofractionated stereotactic radiotherapy after transarterial chemoembolization failure
We report the case of a patient with advanced Hepatocellular carcinoma (HCC) who showed a complete response and a long cancer control with Hypofractionated stereotactic radiotherapy (HSRT) after Transarterial chemoembolization (TACE) failure
Summary
Hepatocellular carcinoma (HCC) is a very heterogeneous disease, and the management of therapeutic approach may be variable and strongly related to patient’s liver dysfunction as well as tumour stage [1]. A patient affected by intermediate or advanced stage HCC is only candidate for a palliative treatment. Transarterial chemoembolization (TACE) is standard treatment of unresectable HCC [2]; prognosis of these patients remains dismal, especially when TACE fails. Hypofractionated stereotactic radiotherapy (HSRT) can lead to a significant benefit for patients affected by intermediate or advanced HCC, alone or combined with TACE [3]. We report the case of a patient with advanced HCC who showed a complete response and a long cancer control with HSRT after TACE failure
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