Case Report
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Apr 14, 2010; 16(14): 1800-1803
Published online Apr 14, 2010. doi: 10.3748/wjg.v16.i14.1800
Surgical spacer placement and proton radiotherapy for unresectable hepatocellular carcinoma
Shohei Komatsu, Yuichi Hori, Takumi Fukumoto, Masao Murakami, Yoshio Hishikawa, Yonson Ku
Shohei Komatsu, Yuichi Hori, Takumi Fukumoto, Yonson Ku, Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
Masao Murakami, Yoshio Hishikawa, Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno 679-5165, Japan
Author contributions: Komatsu S wrote the manuscript and performed the additional data analysis; Hori Y wrote the manuscript; Fukumoto T performed the operation; Murakami M and Hishikawa Y performed the proton radiotherapy; Ku Y contributed by supervising and approving the final manuscript.
Correspondence to: Yuichi Hori, MD, PhD, Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. horiy@med.kobe-u.ac.jp
Telephone: +81-78-3826302 Fax: +81-78-3826307
Received: December 21, 2009
Revised: January 15, 2010
Accepted: January 22, 2010
Published online: April 14, 2010
Abstract

Few potentially curative treatment options exist apart from hepatic resection for patients with huge hepatocellular carcinoma (HCC). Proton radiotherapy is a promising new modality which has an inherent anti-tumor effect against HCC. However, the application of proton radiotherapy for tumors adjacent to the gastrointestinal tract is restricted because the tolerance dose of the intestine is extremely low. A novel two-step treatment was developed with surgical spacer placement and subsequent proton radiotherapy to administer proton radiotherapy with curative intent. This report presents a case of a patient with a huge unresectable HCC treated by this method who achieved disease-free survival of more than 2 years. This new strategy may potentially be an innovative and standard therapy for unresectable HCC in the near future.

Keywords: Hepatocellular carcinoma, Proton radiotherapy, Particle radiotherapy, Operative surgical procedures