Controlling Major Portal Vein Invasion Progression during Lenvatinib Treatment by Carbon-Ion Radiotherapy in Patients with Advanced Hepatocellular Carcinoma

Macrovascular invasion (MVI), including portal vein tumor thrombosis (PVTT), is strongly associated with poor prognosis in patients with hepatocellular carcinoma (HCC). While recommended standard treatment for patients with advanced HCC is systemic therapy, various treatment approaches, including re...

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Published inCase reports in oncology Vol. 14; no. 2; pp. 1103 - 1110
Main Authors Yoshida, Ryoi, Koroki, Keisuke, Makishima, Hirokazu, Ogasawara, Sadahisa, Ishino, Takamasa, Ogawa, Keita, Nakagawa, Miyuki, Fujiwara, Kisako, Unozawa, Hidemi, Iwanaga, Terunao, Fujita, Naoto, Sakuma, Takafumi, Kanzaki, Hiroaki, Kobayashi, Kazufumi, Kanogawa, Naoya, Kiyono, Soichiro, Nakamura, Masato, Kondo, Takayuki, Saito, Tomoko, Nakagawa, Ryo, Suzuki, Eiichiro, Ooka, Yoshihiko, Nakamoto, Shingo, Tawada, Akinobu, Chiba, Tetsuhiro, Arai, Makoto, Kaneko, Takashi, Wakatsuki, Masaru, Kato, Jun, Tsuji, Hiroshi, Kato, Naoya
Format Journal Article
LanguageEnglish
Published Basel, Switzerland S. Karger AG 01.05.2021
Karger Publishers
Subjects
Ablation
Bile ducts
Carbon
carbon-ion radiotherapy
Case Report
Case reports
Cholangitis
Clinical medicine
hepatocellular carcinoma
Liver cancer
macrovascular invasion
Medical prognosis
Metastasis
Patients
Radiation therapy
Thrombosis
Veins & arteries
Macrovascular invasion
Carbon-ion radiotherapy
Hepatocellular carcinoma
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Summary:Macrovascular invasion (MVI), including portal vein tumor thrombosis (PVTT), is strongly associated with poor prognosis in patients with hepatocellular carcinoma (HCC). While recommended standard treatment for patients with advanced HCC is systemic therapy, various treatment approaches, including resection, transarterial chemoembolization, and radiation, have been empirically suggested to improve prognosis by eliminating or controlling MVI. Herein, we report our experience of a case with advanced HCC where MVI was controlled by carbon-ion radiotherapy (CIRT) while on systemic therapy, resulting in a prolonged survival. A female patient with HCC in her early 60s had multiple intrahepatic lesions (maximum 60 mm in diameter) with PVTT. The PVTT of this patient had reached the main trunk of the portal vein despite the use of lenvatinib. The other intrahepatic lesions of the patient, except PVTT, had been controlled by lenvatinib. Therefore, hoping to control PVTT, we attempted CIRT. The patient resumed lenvatinib therapy after the irradiation. During lenvatinib re-treatment, no evident progression of PVTT was observed in the patient.
ISSN:1662-6575
1662-6575
DOI:10.1159/000517440