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Bieu et al. Hepatoma Res 2020;6:49 Hepatoma Research
DOI: 10.20517/2394-5079.2020.39

Case Report Open Access

Combined transarterial chemoembolization and
stereotactic body radiation therapy as a bridge

therapy to liver transplant for hepatocellular
carcinoma

Bui Quang Bieu , Nguyen Dinh Chau , Nguyen Xuan Kien , Le Van Thanh , Vu Van Quang , Thai Doan Ky ,
1
3
2
1
2
1
Nguyen Tien Thinh , Mai Hong Bang 3
3
1 Department of Radiation Oncology and Radiosurgery, Military Central Hospital 108, Hanoi 100000, Vietnam.
2 Department of Hepatobiliary and Pancreatic Surgery, Military Central Hospital 108, Hanoi 100000, Vietnam.
3 Department of Gastroenterology and Hepatobiliary, Military Central Hospital 108, Hanoi 100000, Vietnam.
Correspondence to: Dr. Bui Quang Bieu, Department of Radiation Oncology and Radiosurgery, Military Central Hospital 108,
Hanoi 100000, Vietnam. E-mail: buiquangbieu@gmail.com
How to cite this article: Bieu BQ, Chau ND, Kien NX, Thanh LV, Quang VV, Ky TD, Thinh NT, Bang MH. Combined transarterial
chemoembolization and stereotactic body radiation therapy as a bridge therapy to liver transplant for hepatocellular carcinoma.
Hepatoma Res 2020;6:49. http://dx.doi.org/10.20517/2394-5079.2020.39
Received: 17 Apr 2020 First Decision: 18 May 2020 Revised: 19 Jun 2020 Accepted: 14 Jul 2020 Published: 15 Aug 2020
Received: First Decision: Revised: Accepted: Published:
Academic Editors: Su Pin Choo, Guang-Wen Cao, David Tan Boon Harn Copy Editor: Cai-Hong Wang Production Editor: Jing Yu
Science Editor: Copy Editor: Production Editor: Jing Yu

Abstract
Liver transplant (LT) is the curative treatment for patients with hepatocellular carcinoma (HCC). Bridge therapies
are local treatments given to patients on the LT waitlist, to prevent tumor progression and to reduce the dropout
rate. Case presentation: We reported a 40-year-old man diagnosed with Barcenola-Clinic Liver Cancer BCLC
intermediate stage HCC and Child-Pugh A5 hepatitis B virus cirrhosis who underwent combined bridge therapies
to LT. Firstly, the patient received transarterial chemoembolization (TACE) for two times and showed a partial
response. Then he underwent stereotactic body radiation therapy (SBRT) with a total dose of 45 Gy in 3 fractions.
Three months later, the tumor size and serum protein induced by Vitamin K absence or antagonists-II, alpha
fetoprotein levels decreased gradually. In June 2019 a suitable donor was found and his LT was successfully
performed. Conclusion: We propose that a combination of TACE and SBRT was feasible as bridge therapy for HCC
patients on the LT waitlist.

Keywords: Transarterial chemoembolization, stereotactic body radiation therapy, bridge therapy, hepatocellular
carcinoma, liver transplant

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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