PMC9479073_01
The CT scan of the patient's liver on Dec. 2020. The main metastatic lesion (3.4 x 2.6cm) in the left and caudate lobe of the liver (A), the metastatic nodule (1.5 x 1.1cm) in the hepatic portal (B) and the localized common bile duct compression (C).
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The CT results showed that a main metastatic lesion (3.4 x 2.6 cm) in the left and caudate lobe of the liver, a metastatic nodule (1.5 x 1.1 cm) in the hepatic portal and the localized common bile duct compression ( Figure 1 ).
Via CT to contrast the curative effect between the May 2021 and Dec 2020. The size of the metastatic lesion which in the left and caudate lobe of liver is reduction from 3.4 x 2.6cm to 2.6 x 2.1cm (A, E). The hepatic portal metastatic nodule has disappeared (B, F) and the compressive bile duct has improvement (C, G). The new metastatic lesion (2.7 x 1.7cm) in liver S5 (D, H).
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However, there's a new metastatic lesion (2.7 x 1.7cm) in liver S5 ( Figure 2 ).
Via CT to contrast the curative effect between the Sep 2021 and May 2021. The size of the metastatic lesion which in the left and caudate lobe of liver is increase from 2.6 x 2.1cm to 3.3 x 2.6cm (A, D). The size of the metastatic lesion which in liver S5 is reduction from 2.7 x 1.7cm to 2.3 x 1.1cm (B, E). The new metastatic lesion (1.5 x 1.2cm) in liver S6 (C, F).
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SBRT was aimed at the new liver's lesion (S5) again in May 31, 2021, and the Regorafenib (third-line therapy) is added for treatment. Similarly, the CT results showed a new metastatic lesion (1.5 x 1.2cm) in liver S6 on September 03, 2021 ( Figure 3 ).
Via CT to contrast the curative effect between the Nov 2021 and Sep 2021. The size of the metastatic lesion which in the left and caudate lobe of liver is reduction from 3.3 x 2.6cm to 2.8 x 2.2cm (A, D). The size of the metastatic lesion which in liver S5 is reduction from 2.3 x 1.1cm to 2.0 x 0.9cm (B, E). The metastatic lesion in liver S6 has disappeared (C, F).
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September 04, 2021 after obtaining the consent of the patient and his family after. Surprisingly, after three cycles, the CT results showed that the metastatic lesion which in the left and caudate lobe and S5 of liver is reduction and the lesion of S6 has disappeared ( Figure 4 ).
The change of serum biomarker (A) and timeline of treatment (B). CEA, carcinoembryonic antigen; CA199, carbohydrate antigen 199; PD, disease progression; SBRT, stereotactic body radiation-therapy; PFS, progression-free survival.
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The change of serum biomarker and timeline of treatment was shown in  Figure 5 .