PMC9133506_01
(A) Enhanced CT revealed a mass tumor in the S5/S8 segment of the liver; (B) The tumor thrombus in the inferior vena cava; (C) The tumor thrombus in the right atrium; (D) The tumor thrombus in the left renal vein. CT, computed tomography.
fonc-12-879454-g001.jpg
PMC9133506_01_fonc-12-879454-g001.jpg
f1
The diagnosis was HCC with RA and IVC tumor thrombi with Barcelona clinic liver cancer (BCLC) stage-C (Figure 1).
Region of image-guided radiotherapy. (A) cross-sectional dose distribution map; (B) coronal dose distribution map; (C, D) target delineation of gross tumor volume (GTV) and planted target volume (PTV), the inner circle line is GTV, and the outer circle line is PTV.
fonc-12-879454-g002.jpg
PMC9133506_01_fonc-12-879454-g002.jpg
f2
The dose for HCC recurrence was 50 Gy/25 fractions and for HCC with RA and IVC tumor thrombi was 45 Gy/25 fractions (Figure 2).
Sizes of RA and IVC tumor thrombi before and after 3-month treatment. (A, C, E) Before treatment; (B, D, F) Three months after treatment. IVC, inferior vena cava; RA, right atrium.
fonc-12-879454-g003.jpg
PMC9133506_01_fonc-12-879454-g003.jpg
f3
Tumors (RECIST) v.1.1. The HCC lesion at the junction of S5/S8 segment disappeared, and the IVC/RA thrombus decreased in size (Figure 3).
The timeline scheme of the major clinical events of the patient since diagnosis. HCC, hepatocellular carcinoma; IVC, inferior vena cava; RA, right atrium; RFA, radiofrequency ablation; P, pembrolizumab; L, lenvatinib; PR, partial response.
fonc-12-879454-g004.jpg
PMC9133506_01_fonc-12-879454-g004.jpg
f4
The timeline scheme of the major clinical events of the patient since HCC diagnosis is shown in Figure 4.