Metabolic syndrome–related hepatocellular carcinoma treated by volumetric modulated arc therapy

  • J. Klein Department of Radiation Oncology University of Toronto
  • L.A. Dawson Department of Radiation Oncology University of Toronto
  • T.H. Tran Department of Radiation Oncology University of Toronto
  • O. Adeyi Department of Laboratory Medicine and Pathobiology University of Toronto
  • T. Purdie Department of Radiation Oncology University of Toronto
  • M. Sherman Department of Medicine University of Toronto
  • A. Brade Department of Radiation Oncology University of Toronto
Keywords: Hepatocellular carcinoma, liver, liver cancer, metabolic syndrome, radiotherapy, SBRT, VMAT, IMRT

Abstract

Hepatocellular carcinoma (hcc) is a leading cause of cancer mortality, and its incidence is increasing in developed countries. Risk factors include cirrhosis from viral hepatitis or alcohol abuse. Metabolic syndrome is a newly recognized, but important, risk factor that is likely contributing to the increased incidence of hcc.

Surgery is the therapy of choice for hcc, but local therapies are often contraindicated, usually because of advanced disease or comorbid conditions such as cardiac disease (which is associated with metabolic syndrome). Current radiation therapy techniques such as stereotactic body radiotherapy allow for treatment plans that highly conform to the target and provide excellent sparing of normal structures. Radiation therapy is emerging as a viable option in patients not eligible for surgery or other locoregional therapies.

Here, we report a case of a large hcc presenting in a patient with metabolic syndrome without significant alcohol history or biochemical liver dysfunction. The patient was not a candidate for locoregional therapies because of cardiac and renal comorbidities typical of patients experiencing the long-term sequelae of metabolic syndrome. Treatment using an arc-based volumetric-modulated arc therapy technique allowed for the highest dose of radiation to be delivered to the tumour while the peripheral radiation dose was minimized. A complete local response was confirmed by computed tomography imaging 21 months after treatment completion.


Published
2014-01-14
How to Cite
Klein, J., Dawson, L., Tran, T., Adeyi, O., Purdie, T., Sherman, M., & Brade, A. (2014). Metabolic syndrome–related hepatocellular carcinoma treated by volumetric modulated arc therapy. Current Oncology, 21(2), e340-e344. https://doi.org/10.3747/co.21.1756
Section
Case Report