Yuen Man-Fung, Hon Charmaine, Hui Chee-Kin, Siu Chung-Wah, Lai Ching-Lung
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
J Clin Gastroenterol. 2002 Sep;35(3):272-5. doi: 10.1097/00004836-200209000-00015.
At present, there is no effective treatment of metastatic hepatocellular carcinoma (HCC). Systemic interferon alfa (IFN-alpha) was found to be of some use in patients with inoperable HCC in two randomized trials. We report a case in which metastatic HCC was cured by systemic IFN-alpha 2b in combination with surgery. A patient developed two bilateral pulmonary metastatic HCC nodules 5 months after the resection of the primary HCC. He was treated with systemic IFN-alpha 2b. One lesion completely disappeared. The other lesion showed an initial response but became resistant to the IFN-alpha 2b therapy after reduction in dosage because of the side effects. This was resected in view of the absence of new metastases after 9 months of IFN-alpha 2b therapy. He remained free from recurrence at 59 months of follow-up. A rare, but reversible, complication of retinal cotton wool spots caused by IFN-alpha 2b occurred in this patient. IFN-alpha 2b is partially effective in treating metastatic HCC. The time for its administration can also serve as an observation period, which is vital in deciding whether definitive surgical treatment of any residual lesions is indicated.
目前，转移性肝细胞癌（HCC）尚无有效的治疗方法。在两项随机试验中发现，全身应用干扰素α（IFN-α）对无法手术的HCC患者有一定作用。我们报告一例转移性HCC通过全身应用IFN-α 2b联合手术治愈的病例。一名患者在原发性HCC切除术后5个月出现双侧肺部转移性HCC结节。他接受了全身IFN-α 2b治疗。一个病灶完全消失。另一个病灶最初有反应，但由于副作用在减量后对IFN-α 2b治疗产生耐药。鉴于在IFN-α 2b治疗9个月后没有新的转移灶，对该病灶进行了切除。在59个月的随访中他未出现复发。该患者发生了由IFN-α 2b引起的罕见但可逆的视网膜棉絮斑并发症。IFN-α 2b在治疗转移性HCC方面部分有效。其应用时间也可作为观察期，这对于决定是否对任何残留病灶进行确定性手术治疗至关重要。
