Chen Qiu-Qiu, Chen Chun-Qiao, Liu Jin-Kun, Huang Ming-Yue, Pan Min, Huang Hui
Department of Oncology, People's Hospital of Guilin, Guilin 541002, Guangxi Zhuang Autonomous Region, China.
World J Clin Oncol. 2024 Oct 24;15(10):1342-1350. doi: 10.5306/wjco.v15.i10.1342.
Liver cancer treatment is characterized by multidisciplinary participation and coexistence of multiple treatment methods. Hypofractionated and intensity-modulated radiotherapy is a new precise radiotherapy technique applied to the treatment of systemic malignant tumors. There is a lack of understanding of hypofractionated and intensity-modulated radiotherapy combined with systemic therapy in metastatic hepatocellular carcinoma (HCC).
We report a case of metastatic HCC treated with hypofractionated and intensity-modulated radiotherapy combined with systemic therapy. A 41-year-old man was diagnosed with metastatic HCC (T3N1M1 stage IVB). Because it was found to be in the late stage of cancer and had already metastasized, it was impossible to undergo surgical treatment. In addition to aggressive comprehensive treatment for the primary lesion, local treatment for metastatic cancer can improve the patient's survival potential. Hypofractionated and intensity-modulated radiotherapy can provide a larger single treatment dose within a shorter overall treatment time, and improve the local control rate of the tumor. Follow-up examination demonstrated that the tumor and metastatic lesions had shrunk after therapy. The treatment has showed good efficacy. The patient survived for 18 months without disease progression and stable disease persisted for > 38 months.
Targeted therapy and immunotherapy followed by hypofractionated and intensity-modulated radiotherapy are also effective for advanced metastatic HCC.
肝癌治疗具有多学科参与和多种治疗方法并存的特点。大分割调强放疗是应用于全身恶性肿瘤治疗的一种新型精确放疗技术。目前对于大分割调强放疗联合全身治疗在转移性肝细胞癌(HCC)中的应用尚缺乏认识。
我们报告1例采用大分割调强放疗联合全身治疗的转移性HCC患者。一名41岁男性被诊断为转移性HCC(T3N1M1,IVB期)。由于发现时已处于癌症晚期且已发生转移,无法进行手术治疗。除了对原发灶进行积极的综合治疗外,对转移癌进行局部治疗可提高患者的生存潜力。大分割调强放疗可在较短的总治疗时间内提供更大的单次治疗剂量,并提高肿瘤的局部控制率。随访检查显示,治疗后肿瘤及转移灶缩小。该治疗显示出良好的疗效。患者存活18个月无疾病进展,病情稳定持续超过38个月。
靶向治疗和免疫治疗后序贯大分割调强放疗对晚期转移性HCC也有效。