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Combination of Sorafenib and Intensity Modulated Radiotherapy for Unresectable Hepatocellular Carcinoma

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Abstract

Unresectable hepatocellular carcinoma (HCC) has a poor therapeutic outcome. We report here on a 40-year-old male HCC patient who had undergone partial hepatectomy and was refractory to therapeutic embolization. In addition, the tumour expressed phosphorylated extracellular signal-regulated kinase and CD34. Sorafenib was administered as salvage treatment and resulted in a rapid decline in α-fetoprotein (AFP) levels. However, this was accompanied by a grade 3 skin reaction, which improved as sorafenib dosage was gradually reduced. Unfortunately, reducing the dose of sorafenib also resulted in a rebound in AFP levels and portal vein thrombosis was noted thereafter. Sorafenib 800 mg/day was resumed, but the tumour failed to respond. Intensity-modulated radiation therapy (IMRT) combined with sorafenib was administered, resulting in marked tumour shrinkage and causing recurrence of the systemic skin reaction and development of photosensitivity. The patient survived for 20 months after the start of sorafenib treatment. This case suggests that the combination of sorafenib and IMRT might provide clinical benefits in patients with HCC who express potential targets but fail to respond to sorafenib; however, skin reactions should be monitored.

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Acknowledgements

No sources of funding were used to assist in the preparation of this report. The authors have no conflicts of interest that are directly relevant to the content of this report.

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Authors and Affiliations

  1. Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan

    Chen-Hsi Hsieh, Kuo-Shyang Jeng & Pei-Wei Shueng

  2. Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan

    Kuo-Shyang Jeng

  3. Department of Gastroenterology, Mackay Memorial Hospital, Taipei, Taiwan

    Ching-Chung Lin & Chia-Yuan Liu

  4. Department of Surgical Pathology, Mackay Memorial Hospital, Taipei, Taiwan

    Chi-Kuan Chen

  5. Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan

    Chin-Ping Lin

  6. Department of Radiation Oncology, Mackay Memorial Hospital, Chung-Shan North Road 92, Taipei, 104, Taiwan

    Hung-Chi Tai, Chao-Hsing Wang &  Yu-Jen Chen

  7. Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan

    Pei-Wei Shueng

  8. General Education Center, Oriental Technology Institute, Taipei, Taiwan

    Pei-Wei Shueng

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  1. Chen-Hsi Hsieh
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  2. Kuo-Shyang Jeng
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  3. Ching-Chung Lin
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  4. Chi-Kuan Chen
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  5. Chia-Yuan Liu
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  6. Chin-Ping Lin
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  7. Hung-Chi Tai
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  8. Chao-Hsing Wang
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  9. Pei-Wei Shueng
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  10. Yu-Jen Chen
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Correspondence to Yu-Jen Chen.

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Hsieh, CH., Jeng, KS., Lin, CC. et al. Combination of Sorafenib and Intensity Modulated Radiotherapy for Unresectable Hepatocellular Carcinoma. Clin. Drug Investig. 29, 65–71 (2009). https://doi.org/10.2165/0044011-200929010-00007

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  • DOI: https://doi.org/10.2165/0044011-200929010-00007

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