Takamatsu Manabu, Matsuda Takeru, Kawaguchi Katsunori, Ku Yonson
Dept. of Surgery, Kobe Kaisei Hospital.
Gan To Kagaku Ryoho. 2007 Nov;34(12):2102-4.
A 61-year-old male was admitted for advanced hepatocellular carcinoma (HCC) with multiple lung metastases and tumor thrombus in the portal vein and superior vena cava. At first, we planned to perform transcatheter arterial embolization (TAE) to avoid the rupture of the liver tumor. But, due to the severe liver dysfunction, ie Child-Pugh C and 36% ICG R15, hepatic arterial infusion (HAI) of epirubicin 40 mg was performed. After that, the patient was followed at the outpatient ward and his general condition has gradually improved without a special treatment. At the present, one year and ten month after HAI, the serum alpha-fetoprotein (AFP) is almost within normal limits and CT scans show that HCC with multiple lung metastases, and tumor thrombus in the portal vein and superior vena cava almost disappeared. Although, spontaneous regression of HCC was a rare phenomenon, it might have played a major role in the good anticancer efficacy of this patient as well as high anti-cancer agent sensitivity of his liver tumor.
一名61岁男性因晚期肝细胞癌(HCC)伴多发肺转移及门静脉和上腔静脉肿瘤血栓入院。起初,我们计划进行经导管动脉栓塞术(TAE)以避免肝肿瘤破裂。但是,由于严重肝功能不全,即Child-Pugh C级且吲哚菁绿滞留率(ICG R15)为36%,遂进行了表柔比星40 mg肝动脉灌注(HAI)。此后,患者在门诊病房接受随访,其一般状况在未接受特殊治疗的情况下逐渐改善。目前,HAI后一年零十个月,血清甲胎蛋白(AFP)几乎在正常范围内,CT扫描显示伴多发肺转移的HCC以及门静脉和上腔静脉肿瘤血栓几乎消失。虽然HCC自发消退是一种罕见现象,但它可能在该患者良好的抗癌疗效以及其肝肿瘤的高抗癌药敏感性中发挥了主要作用。