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Stereotactic Body Radiotherapy for Hepatocellular Carcinoma Resulting in a Durable Relapse-Free Survival: A Case Report

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ABSTRACT

The standard of care for localized hepatocellular carcinoma (HCC) is surgical resection. For patients who decline or who are unfit for surgery, stereotactic body radiotherapy (SBRT) is emerging as a viable treatment approach. We present a case of a 77-year-old female in whom an early stage HCC was incidentally discovered. Given her religious edicts as a devout Jehovah’s Witness and her subsequent desire to avoid a blood transfusion, she declined surgical resection or transplant due to the risk of hemorrhage. Ablative therapy was deemed inappropriate given the mass’s size and location adjacent to the inferior vena cava and diaphragm. She was treated with definitive SBRT to a total dose of 60 Gy administered in three 20 Gy fractions every other day. She had a complete response to the treatment and remains without evidence of disease after 39 months of follow-up. Her only treatment-related side effect is a persistent CTCAE Grade 1 myositis on her back overlying the treatment area. We report this case to add to the growing body of literature suggesting SBRT as an effective and safe alternative treatment modality for HCC.

No MeSH data available.


Alpha Fetoprotein LevelsFigure 2: Alpha fetoprotein (AFP) level over time for this patient after stereotactic body radiotherapy (SBRT) treatment. Normal AFP reference range is 0 to 15 ng/mL. This patient’s AFP normalized eight months after SBRT.
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FIG2: Alpha Fetoprotein LevelsFigure 2: Alpha fetoprotein (AFP) level over time for this patient after stereotactic body radiotherapy (SBRT) treatment. Normal AFP reference range is 0 to 15 ng/mL. This patient’s AFP normalized eight months after SBRT.

Mentions: After treatment, she was followed routinely by radiation oncology with serial magnetic resonance imaging (MRI) and serum alpha-fetoprotein (AFP) levels. Her AFP level normalized eight months after SBRT and has remained at 6 ng/mL since that time (Figure 2).


Stereotactic Body Radiotherapy for Hepatocellular Carcinoma Resulting in a Durable Relapse-Free Survival: A Case Report
Alpha Fetoprotein LevelsFigure 2: Alpha fetoprotein (AFP) level over time for this patient after stereotactic body radiotherapy (SBRT) treatment. Normal AFP reference range is 0 to 15 ng/mL. This patient’s AFP normalized eight months after SBRT.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120964&req=5

FIG2: Alpha Fetoprotein LevelsFigure 2: Alpha fetoprotein (AFP) level over time for this patient after stereotactic body radiotherapy (SBRT) treatment. Normal AFP reference range is 0 to 15 ng/mL. This patient’s AFP normalized eight months after SBRT.
Mentions: After treatment, she was followed routinely by radiation oncology with serial magnetic resonance imaging (MRI) and serum alpha-fetoprotein (AFP) levels. Her AFP level normalized eight months after SBRT and has remained at 6 ng/mL since that time (Figure 2).

View Article: PubMed Central - HTML - PubMed

ABSTRACT

The standard of care for localized hepatocellular carcinoma (HCC) is surgical resection. For patients who decline or who are unfit for surgery, stereotactic body radiotherapy (SBRT) is emerging as a viable treatment approach. We present a case of a 77-year-old female in whom an early stage HCC was incidentally discovered. Given her religious edicts as a devout Jehovah’s Witness and her subsequent desire to avoid a blood transfusion, she declined surgical resection or transplant due to the risk of hemorrhage. Ablative therapy was deemed inappropriate given the mass’s size and location adjacent to the inferior vena cava and diaphragm. She was treated with definitive SBRT to a total dose of 60 Gy administered in three 20 Gy fractions every other day. She had a complete response to the treatment and remains without evidence of disease after 39 months of follow-up. Her only treatment-related side effect is a persistent CTCAE Grade 1 myositis on her back overlying the treatment area. We report this case to add to the growing body of literature suggesting SBRT as an effective and safe alternative treatment modality for HCC.

No MeSH data available.