Violari Elena G, Petre Elena N, Feldman Darren R, Erinjeri Joseph P, Brown Karen T, Solomon Stephen B, D'Angelica Michael I, Sofocleous Constantinos T
Department of Radiology, Weill-Cornell Medical College, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA,
Cardiovasc Intervent Radiol. 2015 Apr;38(2):488-93. doi: 10.1007/s00270-014-0924-z. Epub 2014 Jun 18.
We present a case of a patient with stage IIIC metastatic seminoma with a persistent chemorefractory liver lesion. The patient was deemed a poor surgical candidate due to the tumor's aggressive biology with numerous other liver lesions treated with chemotherapy and a relatively high probability for additional recurrences. Further chemotherapy with curative intent was not a feasible option due to the fact that the patient had already received second-line high-dose chemotherapy and four cycles of third-line treatment complicated by renal failure, refractory thrombocytopenia, and debilitating neuropathy. After initial failure of laser, microwave ablation of the chemorefractory liver metastasis resulted in prolonged local tumor control and rendered the patient disease-free for more than 35 months, allowing him to regain an improved quality of life.
我们报告一例 IIIC 期转移性精原细胞瘤患者,其肝脏病灶持续存在且对化疗耐药。由于肿瘤生物学行为侵袭性强,伴有众多其他经化疗治疗的肝脏病灶,且再次复发概率相对较高,该患者被认为手术风险高。鉴于患者已接受二线高剂量化疗以及四个周期的三线治疗,且出现了肾衰竭、难治性血小板减少症和严重神经病变等并发症,以治愈为目的的进一步化疗并非可行选择。在激光治疗最初失败后,对化疗难治性肝转移灶进行微波消融,实现了局部肿瘤的长期控制,使患者无病生存超过 35 个月,生活质量得到改善。