Conversion therapy of a giant hepatocellular carcinoma with portal vein thrombus and inferior vena cava thrombus:A case report and review of literature  

作　　者：Wen-Jie Song Jian Xu Ye Nie Wei-Min Li Jian-Ping Li Li Yang Meng-Qi Wei Kai-Shan Tao 

机构地区：[1]Department of Hepatobiliary Surgery,Xijing Hospital,Air Force Medical University,Xi'an 710032,Shaanxi Province,China [2]Department of Radiotherapy,The First Affiliated Hospital of the Fourth Military Medical University,Xi'an 710032,Shaanxi Province,China [3]State Key Laboratory of Cancer Biology,Department of Pathology,Xijing Hospital and School of Basic Medicine,Xijing Hospital,Air Force Medical University,Xi'an 710000,Shaanxi Province,China [4]Department of Radiology,Xijing Hospital,Air Force Medical University,Xi'an 710032,Shaanxi Province,China

出　　处：《World Journal of Clinical Cases》2024年第16期2847-2855,共9页世界临床病例杂志

摘　　要：BACKGROUND The prognosis of hepatocellular carcinoma(HCC)combined with portal and hepatic vein cancerous thrombosis is poor,for unresectable patients the combination of targeted therapy and immune therapy was the first-line recommended treatment for advanced HCC,with a median survival time of only about 2.7-6 months.In this case report,we present the case of a patient with portal and hepatic vein cancerous thrombosis who achieved pathologic complete response after conversion therapy.CASE SUMMARY In our center,a patient with giant HCC combined with portal vein tumor thrombus and hepatic vein tumor thrombus was treated with transcatheter arterial chemoembolization(TACE),radiotherapy,targeted therapy and immunotherapy,and was continuously given icaritin soft capsules for oral regulation.After 7 months of conversion therapy,the patient's tumor shrank and the tumor thrombus subsided significantly.The pathology of surgical resection was in complete remission,and there was no progression in the postoperative follow-up for 7 months,which provided a basis for the future strategy of combined conversion therapy.CONCLUSION In this case,atezolizumab,bevacizumab,icaritin soft capsules combined with radiotherapy and TACE had a good effect.For patients with hepatocellular carcinoma combined with hepatic vein/inferior vena cava tumor thrombus,adopting a high-intensity,multimodal proactive strategy under the guidance of multidisciplinary team(MDT)is an important attempt to break through the current treatment dilemma.

关 键 词：Hepatocellular carcinoma ICARITIN Conversion DOWNSTAGING Portal vein thrombus Case report 

分 类 号：R735.7[医药卫生—肿瘤] R543[医药卫生—临床医学]