Radiotherapy is Effective in the Treatment of Hepatocellular Carcinoma with Right Atrium Invasion - Report of A Case

Hepatocellular carcinoma (HCC) is a common malignant neoplasm in East Asia. HCC has the tendency to invade vessels, mainly the portal venous system. Right atrium metastasis through venous invasion is a rare condition with grave prognosis. Surgical resection of intra-atrial tumors is technically difficult and it is too invasive for the seriously ill patients. Here, we present a 58-year-old male patient of HCC with hepatic veins, inferior vena cava, and right atrium invasion, who received well-designed three-dimensional conformal radiotherapy (totally 60 Gy 33 fractions), followed by one course of intra-arterial chemotherapy with cisplatin (65 mg/m2 infusion for 6 hours) and 5-fluorouracil (2,200 mg/m2 infusion for 24 hours). Serum alpha-fetoprotein was markedly decreased, and size of tumor thrombus was shrinkage. This patient survived for 15 more months. Therefore, for HCC patients with right atrium metastasis, three-dimensional conformal radiotherapy plus chemotherapy may be an effective salvage treatment.