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Case report
peer-reviewed

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



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.



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Case report
peer-reviewed

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


Author Information

Samual Francis

Radiation Oncology, University of Utah Huntsman Cancer Hospital

Ned Williams

Radiation Oncology, University of Utah Huntsman Cancer Hospital

Christopher J. Anker

Radiation Oncology, University of Vermont

Akram Shaaban

Radiology, University of Utah Huntsman Cancer Hospital

Robin Kim

General Surgery, University of Utah School of Medicine

Dennis Shrieve

Radiation Oncology, University of Utah Huntsman Cancer Hospital

Jonathan Tward Corresponding Author

Radiation Oncology, University of Utah Huntsman Cancer Hospital


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared the following conflicts of interest: Financial relationships: Jonathan Tward declare(s) a grant from Myriad Genetics. The grant is not relevant to this work.


Case report
peer-reviewed

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


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Case report
peer-reviewed

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

  • Author Information
    Samual Francis

    Radiation Oncology, University of Utah Huntsman Cancer Hospital

    Ned Williams

    Radiation Oncology, University of Utah Huntsman Cancer Hospital

    Christopher J. Anker

    Radiation Oncology, University of Vermont

    Akram Shaaban

    Radiology, University of Utah Huntsman Cancer Hospital

    Robin Kim

    General Surgery, University of Utah School of Medicine

    Dennis Shrieve

    Radiation Oncology, University of Utah Huntsman Cancer Hospital

    Jonathan Tward Corresponding Author

    Radiation Oncology, University of Utah Huntsman Cancer Hospital


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared the following conflicts of interest: Financial relationships: Jonathan Tward declare(s) a grant from Myriad Genetics. The grant is not relevant to this work.

    Acknowledgements


    Article Information

    Published: October 24, 2016

    DOI

    10.7759/cureus.841

    Cite this article as:

    Francis S, Williams N, Anker C J, et al. (October 24, 2016) Stereotactic Body Radiotherapy for Hepatocellular Carcinoma Resulting in a Durable Relapse-Free Survival: A Case Report. Cureus 8(10): e841. doi:10.7759/cureus.841

    Publication history

    Received by Cureus: May 12, 2016
    Peer review began: May 13, 2016
    Peer review concluded: October 10, 2016
    Published: October 24, 2016

    Copyright

    © Copyright 2016
    Francis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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.



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Create a free account to continue reading this article.

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Samual Francis

Radiation Oncology, University of Utah Huntsman Cancer Hospital

Ned Williams

Radiation Oncology, University of Utah Huntsman Cancer Hospital

Christopher J. Anker

Radiation Oncology, University of Vermont

Akram Shaaban

Radiology, University of Utah Huntsman Cancer Hospital

Robin Kim

General Surgery, University of Utah School of Medicine

Dennis Shrieve

Radiation Oncology, University of Utah Huntsman Cancer Hospital

Jonathan Tward

Radiation Oncology, University of Utah Huntsman Cancer Hospital

For correspondence:
jonathan.tward@hci.utah.edu

Samual Francis

Radiation Oncology, University of Utah Huntsman Cancer Hospital

Ned Williams

Radiation Oncology, University of Utah Huntsman Cancer Hospital

Christopher J. Anker

Radiation Oncology, University of Vermont

Akram Shaaban

Radiology, University of Utah Huntsman Cancer Hospital

Robin Kim

General Surgery, University of Utah School of Medicine

Dennis Shrieve

Radiation Oncology, University of Utah Huntsman Cancer Hospital

Jonathan Tward

Radiation Oncology, University of Utah Huntsman Cancer Hospital

For correspondence:
jonathan.tward@hci.utah.edu