Combination therapy strategy based on selective internal radiation therapy as conversion therapy for inoperable giant hepatocellular carcinoma:A case report  

作　　者：Ming-Zhi Hao Hai-Lan Lin Yu-Bin Hu Qi-Zhong Chen Zhang-Xian Chen Lin-Bin Qiu Duan-Yu Lin Hui Zhang De-Chun Zheng Zhu-Ting Fang Jing-Feng Liu 

机构地区：[1]Department of Tumor Interventional Radiology,Clinical Ocology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou 350014,Fujian Province,China [2]Department of Oncology and Vascular Interventional Radiology,Clinical Oncology School of Fujian Medical University,Fuzhou 350014,Fujian Province,China [3]Department of Nuclear Medicine,Clinical Oncology School of Fujian Medical University,Fuzhou 350014,Fujian Province,China [4]Department of Hepatopancreatobiliary Surgical Oncology,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou 350014,Fujian Province,China [5]Department of Radiology,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou 350014,Fujian Province,China [6]Department of Oncology and Vascular Interventional Radiology,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou 350014,Fujian Province,China [7]Department of Hepatobiliary Surgery,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou 350014,Fujian Province,China

出　　处：《World Journal of Gastrointestinal Oncology》2025年第3期410-417,共8页世界胃肠肿瘤学杂志(英文)

基　　金：The Fujian Key Laboratory of Translational Cancer Medicine and The Yttrium Little Red Flower Health Fund Project of Henan Sunshine Medical and Health Development Foundation,No.HKP2024001.

摘　　要：BACKGROUND Hepatocellular carcinoma(HCC)has become a growing health concern globally.Microvascular invasion and high tumor burden are key factors limiting the curative effect of selective internal radiation therapy(SIRT).CASE SUMMARY This case study reports a 49-year-old woman who was diagnosed with China Liver Cancer Staging(CNLC)IIIa HCC and>15 cm tumor diameter.Initially,due to insufficient future liver remnant and vascular invasion,the tumor was unresectable;however,radical hepatectomy was performed after successful conversion therapy with SIRT using yttrium-90(90Y)resin microspheres followed by hepatic arterial infusion chemotherapy(HAIC)with tyrosine kinase inhibitor(TKI)and anti-programmed death-1(PD-1)antibody.SIRT using 90Y resin microspheres was given by the right hepatic artery and chemoembolization was simultaneously performed in the tumor’s feeding vessels from the right diaphragmatic artery.HAIC was followed every three weeks with lenvatinib and tislelizumab.At 4 months post-SIRT,the tumor was downstaged to CNLC Ib and the patient successfully underwent hepatectomy.The histopathological examination of the resected specimen showed extensive necrosis.CONCLUSION This case study provides evidence for an integrated treatment strategy combining SIRT and HAIC with TKI and anti-PD-1 antibodies for patients with large HCC and microvascular invasion.Further confirmatory trials are required in the future.

关 键 词：Selective internal radiation therapy Hepatic arterial infusion chemotherapy Yttrium-90 resin microspheres Hepatocellular carcinoma Conversion therapy Case report 

分 类 号：R73[医药卫生—肿瘤]