Hypofractionated and intensity-modulated radiotherapy combined with systemic therapy in metastatic hepatocellular carcinoma: A case report

Background: Liver cancer treatment is characterized by multidisciplinary participation and coexistence of multiple treatment methods. Hypofractionated and intensity-modulated radiotherapy is a new precise radiotherapy technique applied to the treatment of systemic malignant tumors. There is a lack of understanding of hypofractionated and intensity-modulated radiotherapy combined with systemic therapy in metastatic hepatocellular carcinoma (HCC).

Case summary: We report a case of metastatic HCC treated with hypofractionated and intensity-modulated radiotherapy combined with systemic therapy. A 41-year-old man was diagnosed with metastatic HCC (T3N1M1 stage IVB). Because it was found to be in the late stage of cancer and had already metastasized, it was impossible to undergo surgical treatment. In addition to aggressive comprehensive treatment for the primary lesion, local treatment for metastatic cancer can improve the patient's survival potential. Hypofractionated and intensity-modulated radiotherapy can provide a larger single treatment dose within a shorter overall treatment time, and improve the local control rate of the tumor. Follow-up examination demonstrated that the tumor and metastatic lesions had shrunk after therapy. The treatment has showed good efficacy. The patient survived for 18 months without disease progression and stable disease persisted for > 38 months.

Conclusion: Targeted therapy and immunotherapy followed by hypofractionated and intensity-modulated radiotherapy are also effective for advanced metastatic HCC.