Anticancer research · 2025
Carbon-ion Radiotherapy for Hepatocellular Cancer Arising in Transplanted Liver Tissue.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Hayashi Kazuhiko, Suzuki Osamu, Ichise Koji, Uchida Hirofumi, Nagano Fumiko, Hasegawa Azusa, Shimizu Shinichi, Fujimoto Jiro, Ogawa Kazuhiko
Аннотация
BACKGROUND/AIM: Few studies have reported the effects of radiotherapy on hepatocellular carcinoma (HCC) arising in transplanted liver tissue, and its safety and efficacy remain unclear. Here, we report a case of carbon-ion radiotherapy (CIRT) for HCC arising in transplanted liver tissue.
CASE REPORT: The patient was a 51-year-old man with a performance status score of 0 at the time of HCC referral. He had undergone living-donor liver transplantation for cirrhosis caused by Wilson disease approximately 13 years prior to CIRT for HCC. One year and four months prior to CIRT, a 38 mm HCC mass was diagnosed using ultrasound, computed tomography, and magnetic resonance imaging. Due to the history of liver transplantation, the surgeon determined that surgery for HCC was a high-risk procedure; consequently, the patient underwent transcatheter arterial chemoembolization (TACE). However, the lesions gradually grew. One year and four months after TACE, the patient was diagnosed with recurrent HCC (48 mm; rT1bN0M0, r-stage IB) based on imaging alone. Surgical management was determined to be challenging, and TACE was not considered effective in this case. The patient's liver dysfunction, assessed using the Child-Pugh classification, was favorable at 6 points (class A). Therefore, the patient received CIRT at 60 Gy (RBE) in four fractions to reduce radiation-induced toxicity. No acute adverse events were observed. A grade 2 increase in γ-glutamyl transpeptidase was observed 24 months after CIRT, which returned to normal naturally. The HCC showed no recurrence at 4 years and 7 months after the final follow-up. Two months later, the patient died of leukemia without any signs of HCC recurrence.
CONCLUSION: This case indicated that CIRT is a safe treatment option for HCC arising from transplanted liver tissue.
CASE REPORT: The patient was a 51-year-old man with a performance status score of 0 at the time of HCC referral. He had undergone living-donor liver transplantation for cirrhosis caused by Wilson disease approximately 13 years prior to CIRT for HCC. One year and four months prior to CIRT, a 38 mm HCC mass was diagnosed using ultrasound, computed tomography, and magnetic resonance imaging. Due to the history of liver transplantation, the surgeon determined that surgery for HCC was a high-risk procedure; consequently, the patient underwent transcatheter arterial chemoembolization (TACE). However, the lesions gradually grew. One year and four months after TACE, the patient was diagnosed with recurrent HCC (48 mm; rT1bN0M0, r-stage IB) based on imaging alone. Surgical management was determined to be challenging, and TACE was not considered effective in this case. The patient's liver dysfunction, assessed using the Child-Pugh classification, was favorable at 6 points (class A). Therefore, the patient received CIRT at 60 Gy (RBE) in four fractions to reduce radiation-induced toxicity. No acute adverse events were observed. A grade 2 increase in γ-glutamyl transpeptidase was observed 24 months after CIRT, which returned to normal naturally. The HCC showed no recurrence at 4 years and 7 months after the final follow-up. Two months later, the patient died of leukemia without any signs of HCC recurrence.
CONCLUSION: This case indicated that CIRT is a safe treatment option for HCC arising from transplanted liver tissue.