Clinical Drug Investigation

, Volume 29, Issue 1, pp 65–71 | Cite as

Combination of Sorafenib and Intensity Modulated Radiotherapy for Unresectable Hepatocellular Carcinoma

  • Chen-Hsi Hsieh
  • Kuo-Shyang Jeng
  • Ching-Chung Lin
  • Chi-Kuan Chen
  • Chia-Yuan Liu
  • Chin-Ping Lin
  • Hung-Chi Tai
  • Chao-Hsing Wang
  • Pei-Wei Shueng
  • Yu-Jen Chen
Case Reports


Unresectable hepatocellular carcinoma (HCC) has a poor therapeutic outcome. We report here on a 40-year-old male HCC patient who had undergone partial hepatectomy and was refractory to therapeutic embolization. In addition, the tumour expressed phosphorylated extracellular signal-regulated kinase and CD34. Sorafenib was administered as salvage treatment and resulted in a rapid decline in α-fetoprotein (AFP) levels. However, this was accompanied by a grade 3 skin reaction, which improved as sorafenib dosage was gradually reduced. Unfortunately, reducing the dose of sorafenib also resulted in a rebound in AFP levels and portal vein thrombosis was noted thereafter. Sorafenib 800 mg/day was resumed, but the tumour failed to respond. Intensity-modulated radiation therapy (IMRT) combined with sorafenib was administered, resulting in marked tumour shrinkage and causing recurrence of the systemic skin reaction and development of photosensitivity. The patient survived for 20 months after the start of sorafenib treatment. This case suggests that the combination of sorafenib and IMRT might provide clinical benefits in patients with HCC who express potential targets but fail to respond to sorafenib; however, skin reactions should be monitored.



No sources of funding were used to assist in the preparation of this report. The authors have no conflicts of interest that are directly relevant to the content of this report.


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Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  • Chen-Hsi Hsieh
    • 1
  • Kuo-Shyang Jeng
    • 1
    • 2
  • Ching-Chung Lin
    • 3
  • Chi-Kuan Chen
    • 4
  • Chia-Yuan Liu
    • 3
  • Chin-Ping Lin
    • 5
  • Hung-Chi Tai
    • 6
  • Chao-Hsing Wang
    • 6
  • Pei-Wei Shueng
    • 1
    • 7
    • 8
  • Yu-Jen Chen
    • 6
  1. 1.Department of Radiation OncologyFar Eastern Memorial HospitalTaipeiTaiwan
  2. 2.Department of SurgeryMackay Memorial HospitalTaipeiTaiwan
  3. 3.Department of GastroenterologyMackay Memorial HospitalTaipeiTaiwan
  4. 4.Department of Surgical PathologyMackay Memorial HospitalTaipeiTaiwan
  5. 5.Department of Medical ResearchMackay Memorial HospitalTaipeiTaiwan
  6. 6.Department of Radiation OncologyMackay Memorial HospitalTaipeiTaiwan
  7. 7.Department of Radiation OncologyNational Defense Medical CenterTaipeiTaiwan
  8. 8.General Education CenterOriental Technology InstituteTaipeiTaiwan

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