Brief reportSelective Internal Radiation Therapy of Hepatocellular Carcinoma: Potential Hepatopulmonary Shunt Reduction after Sorafenib Administration
Section snippets
Materials and Methods
A waiver of institutional review board requirements was obtained because of the retrospective character of this study.
Results
Four of seven patients with high HPS as a contraindication for SIRT (three men, one woman; mean age, 62.5 y; age range, 50–83 y) received sorafenib for an average of 138 days (range, 72–297 d) before a repeat angiogram followed by lung shunt calculation. The remaining three patients were not rescheduled for SIRT because of progressive disease and increasingly reduced liver function. In three of the four patients who were reevaluated, the initial estimated lung dose was > 30 Gy. In one patient,
Discussion
The administration of sorafenib may lead to a reduction of HPS in patients with advanced stage HCC. We first considered the reevaluation of patients with increased HPS for SIRT during CT follow-up examinations of patients receiving sorafenib treatment. Reduction of arteriovenous shunts could be observed on CT, which encouraged us to repeat DSA in conjunction with MAA injection. Eventually, these patients became eligible for SIRT despite initially increased HPS. CT and angiographic features of
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None of the authors have identified a conflict of interest.