Mr. Li, a 66-year-old man, is an optimistic person. He had chronic hepatitis B for more than 30 years. In November 2010, he was diagnosed with liver cancer, a devastating blow for him and his family. He did not let the disease defeat him and bravely underwent surgery to remove a 5.5 cm liver tumor. Pathology showed hepatocellular carcinoma of the right hepatic lobe, grade II. After surgery, to help prevent recurrence, he actively cooperated with interventional therapy.

However, the disease returned. In 2015, new lesions appeared in his liver. Faced with recurrence, the patient and his family did not give up; they followed the doctor’s advice and received biotherapy and immunotherapy. The patient maintained a positive attitude and believed he could overcome the illness.

In August 2015, fate struck again: a PET-CT showed a nodule in the right occipital lobe with surrounding edema, and enlarged right hilar and mediastinal lymph nodes, suspicious for metastasis. The family fell into despair but decided to pursue active treatment. In August 2015 the patient came to Professor Wang Enmin. After assessing his condition, we decided on staged CyberKnife irradiation to different sites. We delivered precise CyberKnife treatment to the right occipital lesion at a dose of 28 Gy in 2 fractions (14 Gy × 2); after treatment he received mannitol plus dexamethasone for dehydration therapy. The right hilar lung lesion received palliative, precise CyberKnife irradiation at 40 Gy in 8 fractions (5 Gy × 8). The CyberKnife treatments proceeded smoothly and the patient reported no discomfort. One month after discharge, follow-up AFP levels had fallen significantly.

In December 2018, follow-up PET-CT showed no abnormalities in the liver but revealed a left adrenal nodule measuring 2.1 × 1.3 cm, suspicious for metastasis. In January 2019, we treated the left adrenal lesion with CyberKnife at 31.2 Gy in 4 fractions.

In January 2021, a new lesion was found in the right adrenal gland, and we immediately treated the new right adrenal lesion with CyberKnife at 32 Gy in 4 fractions.

After multiple CyberKnife treatments, the patient has been doing well and attends regular follow-ups.Time passed. In February 2025, contrast MRI of the brain suggested a recurrence of the right occipital metastasis with hemorrhage. After careful review by Professor Wang Enmin, this was considered radiation-induced brain injury. The patient received mannitol dehydration therapy and afterward happily returned home to recuperate.