Radiotherapy for multiple brain metastases from hepatocellular carcinomas

A 78-year-old man with liver cirrhosis was found to have multiple hepatocellular carcinomas (HCCs) and underwent 3 sessions of transcatheter arterial chemoembolization. Fourteen months after diagnosis, the patient presented with left hemiparesis. Contrast-enhanced magnetic resonance imaging showed multiple metastases with ring-shaped enhancement in the cerebrum and cerebellum. There were no metastases to other organs. The metastatic lesions almost completely disappeared after whole-brain radiotherapy with a total dose of 50 Gy. Neurologic symptoms decreased, and the patient's quality of life improved. The patient underwent 2 more sessions of transcatheter arterial chemoembolization. Twelve months after the diagnosis of brain metastasis, the patient remains alive. The present case indicates that radiotherapy can improve quality of life and prolong survival in some patients with brain metastases from HCCs.