SUCCESSFUL TREATMENT OF TRANSARTERIAL CHEMOEMBOLIZATION COMBINED WITH STEREOTACTIC ABLATIVE RADIOTHERAPY FOR RECURRENT HEPATOCELLULAR CARCINOMA AFTER LIVER TRANSPLANTATION: A CASE REPORT

併用經導管動脈化學栓塞及立體定位消融放射治療成功治療肝癌病人移植後復發：個案報告

羅承翔(Cheng-Hsiang Lo) ； 黃文彥(Wen-Yen Huang) ； 趙興隆(Hsing-Lung Chao) ； 林昆澤(Kun-Tze Lin) ； 陳昌明(Chang-Ming Chen) ； 楊仁富(Jen-Fu Yang) ； 張智凱(Jhih-Kai Jhang) ； 林群書(Chun-Shu Lin)

《放射治療與腫瘤學》 24卷2期 (2017/06) Pp. 161-166

https://doi.org/10.6316/TRO/201624(2)161

摘要

We describe a rare case of recurrent hepatocellular carcinoma (HCC) after liver transplantation (LT). A 69-year-old male underwent orthotopic LT for primary HCC outside of Milan criteria due to incomplete embolization. Sixteen months after LT, contrast-enhanced computed tomography (CT) showed two recurrent tumors in the liver graft. The patient underwent combined TACE and stereotactic ablative radiotherapy (SABR) to treat the recurrent lesions. Twenty-eight months after completion of combined treatment, the patient is doing well without experiencing any acute or chronic adverse effect. Surveillance images demonstrated complete regression and no evidence of recurrence. This case suggests that this dual-modality treatment in the post-transplant setting may help to improve local control and potentially survival in those recipients who develop recurrent HCC within the liver graft.

關鍵字

Hepatocellular carcinoma ； Liver transplantation ； Transarterial chemoembolization ； Stereotactic ablative radiotherapy ； Stereotactic body radiotherapy

並列摘要

我們報告一個罕見肝臟移植後再復發之肝癌個案：一名69歲原發肝癌男性因栓塞效果不佳，在不符合米蘭規約（Milan criteria）條件下接受原位肝臟移植。移植後16個月之電腦斷層影像顯示肝臟植體出現兩處復發病灶，病人因此接受經導管動脈化學栓塞及立體定位消融放射治療之合併療法。病人對此治療方式耐受良好，在治療結束後追蹤的28個月中並無出現任何急性或慢性之副作用。後續追蹤的影像檢查顯示治療部位完全緩解且無復發跡象。此個案報告顯示，在肝臟移植後於肝植體復發之病人，併用經導管動脈化學栓塞及立體定位消融放射治療，可能改善局部腫瘤控制及病人存活。

並列關鍵字

肝癌 ； 肝臟移植 ； 經導管動脈化學栓塞 ； 立體定位消融放射治療 ； 身體立體定位放射治療