Gen Yasuyuki, Kimura Hiroyuki, Akitake Reiko, Sakai Aya, Fukui Akifumi, Takao Toshitatsu, Ikezawa Satoshi, Masuda Atsuhiro, Takashima Hidetaka, Funatsu Eiji, Nakamura Hideki, Okuyama Yusuke, Arai Masahiro, Yagi Nobuaki, Kutsumi Hiromu, Fujimoto Sotaro, Takeuchi Yoshito
Dept. of Gastroenterology, Kyoto First Red Cross Hospital.
Gan To Kagaku Ryoho. 2006 Apr;33(4):505-8.
A 72-year-old man with type C liver cirrhosis had suffered from hepatocellular carcinoma (HCC) since April, 2001. HCC spread diffusely all over the right lobe of his liver, and the serum alpha-fetoprotein (AFP) value increased up to 42,696 ng/ml in June of 2004. He was implanted with a port-catheter system, and hepatic arterial infusion chemotherapy (HAIC) using low-dose of CDDP and 5-FU was started. However, it was not effective and after 4 months, the serum AFP level increased up to 755,030 ng/ml, ascites appeared, and gastro-esophageal varices also spread. No definite metastasis was detected, then we started to second-line chemotherapy. He was then given HAIC using CDDP powder for intraarterial use (CDDP 50 mg/m(2)/20 min, monthly). After 3 courses, the serum AFP level decreased to 9 10 ng/ml, and abdominal CT revealed that the main tumor had regressed and ascites had disappeared. After one more course, the serum AFP value decreased to 8 ng/ml and complete response was achieved on abdominal CT imaging. There was no major complication related to the chemotherapy. HAIC for advanced HCC using LFP has been reported to achieve favorable results, but no other regimens have been proved to the standard for HCC. HAIC using CDDP powder for advanced HCC may be beneficial as the second-line chemotherapy.
一名72岁的丙型肝硬化男性自2001年4月起患有肝细胞癌（HCC）。HCC广泛扩散至其肝脏右叶，2004年6月血清甲胎蛋白（AFP）值升至42,696 ng/ml。他接受了经皮肝穿刺导管系统植入，并开始使用低剂量顺铂和5-氟尿嘧啶进行肝动脉灌注化疗（HAIC）。然而，治疗无效，4个月后，血清AFP水平升至755,030 ng/ml，出现腹水，胃食管静脉曲张也有所扩散。未检测到明确转移，随后我们开始二线化疗。之后他接受了使用动脉内用顺铂粉（顺铂50 mg/m²/20分钟，每月一次）的HAIC。3个疗程后，血清AFP水平降至910 ng/ml，腹部CT显示主要肿瘤缩小，腹水消失。再进行一个疗程后，血清AFP值降至8 ng/ml，腹部CT成像达到完全缓解。化疗未出现重大并发症。据报道，使用LFP的HAIC治疗晚期HCC取得了良好效果，但尚无其他方案被证明是HCC的标准治疗方案。使用顺铂粉的HAIC作为晚期HCC的二线化疗可能有益。
