Okazaki N, Yoshida T, Yoshino M, Okada S, Shimada Y, Moriyama N, Takayasu K
Department of Internal Medicine, National Cancer Center Hospital, Tokyo.
Jpn J Clin Oncol. 1991 Feb;21(1):69-74.
A 61-year-old man received systemic mitoxantrone chemotherapy following transarterial embolization of a large hepatocellular carcinoma with extensive intrahepatic, lung and bone metastases. His serum alpha-fetroprotein levels were 199,000 ng/ml prior to chemotherapy. He was given 10 mg mitoxantrone/m2 (14 mg/dose) intravenously every three weeks, and showed a rapid decrease in his serum levels of alpha-fetoprotein. There was almost complete resolution of the multiple bilateral metastatic lung nodules at five weeks and a marked decrease in the size of the intrahepatic metastatic nodules by seven weeks. The primary tumor, however, which had been previously treated by transarterial embolization, only underwent a 33% reduction in size according to WHO criteria. This occurred despite the disappearance, demonstrated by contrast enhanced computed tomography, of all viable tumor tissue. Ultrasonography also revealed only a minor regression, and could demonstrate no changes in the tumor echo pattern. The response pattern observed in this patient indicates the response to chemotherapy for hepatocellular carcinoma to be modified by prior transarterial embolization.
一名61岁男性在对广泛肝内、肺和骨转移的大肝细胞癌进行经动脉栓塞后接受了全身米托蒽醌化疗。化疗前他的血清甲胎蛋白水平为199,000 ng/ml。每三周静脉给予他10 mg米托蒽醌/m²（14 mg/剂量），其血清甲胎蛋白水平迅速下降。五周时双侧多发转移性肺结节几乎完全消退，七周时肝内转移结节大小明显减小。然而，先前经动脉栓塞治疗过的原发性肿瘤，根据世界卫生组织标准，大小仅缩小了33%。尽管增强计算机断层扫描显示所有存活肿瘤组织均消失，但仍出现这种情况。超声检查也仅显示轻微消退，且未发现肿瘤回声模式有变化。该患者观察到的反应模式表明，肝细胞癌对化疗的反应会因先前的经动脉栓塞而改变。
