Hepatocellular carcinoma (HCC) is the third most common malignancy in Korea. Despite recent advances in the area of
HCC, a considerable number of HCC patients require non-surgical treatments and systemic therapies because of poor liver
function or intermediate to advanced cancer stages at the time of diagnosis. Unfortunately, chemotherapy for advanced HCC
has limited response rates and provides a marginal survival benefit. Several studies have supported potential advantages of
hepatic arterial infusion chemotherapy (HAIC), designed to improve chemotherapy benefits by increasing the amount of
chemotherapy delivered to the site of the tumor and to minimizes the side-effects of the chemotherapy. However, there hasn’t
been any report showing different responses between systemic chemotherapy and HAIC for the same patient. Herein, we
report a case of HCC showing progressive disease in systemic chemotherapy, but partial response in HAIC with the same
regimen for the same patient with portal vein thrombosis. This case implies HAIC might be alternative option for HCC
patient showing ineffective response to systemic chemotherapy, even with the same regimen.