title: 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.
authors.affiliation: Radiation Oncology, University of Utah Huntsman Cancer Hospital.
authors.forename: Samual
authors.initials: S
authors.lastname: Francis
authors.affiliation: Radiation Oncology, University of Utah Huntsman Cancer Hospital.
authors.forename: Ned
authors.initials: N
authors.lastname: Williams
authors.affiliation: Radiation Oncology, University of Vermont.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Anker
authors.affiliation: Radiology, University of Utah Huntsman Cancer Hospital.
authors.forename: Akram
authors.initials: A
authors.lastname: Shaaban
authors.affiliation: General Surgery, University of Utah School of Medicine.
authors.forename: Robin
authors.initials: R
authors.lastname: Kim
authors.affiliation: Radiation Oncology, University of Utah Huntsman Cancer Hospital.
authors.forename: Dennis
authors.initials: D
authors.lastname: Shrieve
authors.affiliation: Radiation Oncology, University of Utah Huntsman Cancer Hospital.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Tward
keywords: erythropoietic protoporphyria; hepatocellular carcinoma; liver cancer; stereotactic body radiotherapy