Effective relief of obstructive jaundice in a patient with nonresectable icteric-type hepatocellular carcinoma by external beam radiation therapy: case report.

We report on a 62-year-old woman with nonresectable icteric-type hepatocellular carcinoma who developed obstructive jaundice due to tumor thrombi in the common hepatic duct. External beam radiation therapy with total dose of 38 Gy was given in 10 fractions within 4 weeks. The serum bilirubin level progressively decreased from 30.0 to 1.7 mg/dl with a concomitant reduction of tumor size in the 2 months following radiotherapy. Serum alpha-fetoprotein level decreased from greater than 10,000 to 6540 ng/ml after radiotherapy but increased again due to new growth of tumors. The patient was subsequently treated by transcatheter arterial chemoembolization and was still alive 8 months after the diagnosis of nonresectable icteric-type hepatocellular carcinoma. This result suggests that external beam radiation therapy may be beneficial in some patients with nonresectable icteric-type hepatocellular carcinoma. When combined with other conventional therapies, radiation therapy may play an important role in the treatment of hepatocellular carcinoma.