Author:
Goodchild Sarah,Mills Matthew N.,Palm Russell F.,Hoffe Sarah E.,Frakes Jessica M.
Abstract
Abstract
Integration of locoregional therapies such as stereotactic body radiation therapy (SBRT) is increasing in the treatment of hepatocellular carcinoma (HCC), the most common primary cancer of the liver. A 68-year-old man with hepatitis C was diagnosed with American Joint Committee on Cancer stage 2 (cT2N0M0), Child-Pugh class A, multifocal HCC. He completed adaptive MR-guided stereotactic body radiation therapy (MRgSBRT) for a total dose of 50 Gy in 5 fractions. At the 3-month follow-up, a three-phase abdominal CT showed a decrease in the size of the treated lesion and a new gastric fistula was noted. He started a proton pump inhibitor and remained under close observation. At the 6-month follow-up, imaging showed a decrease in tumor size with continued evidence of a contained fistula. Severe side effects are possible following MRgSBRT to the liver, even with the utilization of adaptive treatment, highlighting the importance of attention to high-dose isodose lines near normal tissues and adherence to dose constraints.
Publisher
Anderson Publishing, Ltd.
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