양측 담관을 침범한 간문부 간세포암을 토모테라피를 이용한 항암화학-방사선 동시요법으로 치료한 1예

Abstract

Hepatocellular carcinoma (HCC) usually takes an intrahepatic spread via portal vein branches, and the incidence of portal vein invasion is reported to be 34～40% in surgical resected series. On the other hand, the rate of intrabiliary growth of HCC is rare, ranging from 2.3～13% in surgical and autopsy cases. Here, we report a case of the patient treated with localized concurrent chemo-radiation therapy (CCRT) for hilar HCC with invasion of bilateral bile duct. The tomotherapy was performed with a total radiation dose of 4,240 cGy (20 times, 212 cGy/time) on tumor bed and hepatic arterial infusion of 5-fluorouracil (1,000 mg/day, day 1～5 and day 16～20) and cisplatin (60 mg/m2, day 3 and day 18) was done via implantable port system during the radiotherapy. After that, tumor size and tumor marker was decreased and treatment response was achieved as partial response. CCRT is expected as one of the appropriated treatment options for inoperable HCC with bile duct invasion