Morii Kazuhiko, Aoyama Yuhki, Nakamura Shinichiro, Okushin Hiroaki
Department of Hepatology, Japanese Red Cross Society Himeji Hospital, Japan.
Intern Med. 2015;54(20):2609-13. doi: 10.2169/internalmedicine.54.4430. Epub 2015 Oct 15.
A 72-year-old man with advanced hepatocellular carcinoma and decompensated hepatitis C virus-related cirrhosis suffered from a metastatic femoral fracture. After undergoing radiotherapy, he was only treated with supportive care, except for the administration of zoledronic acid (ZA). Thereafter, the initially elevated serum α-fetoprotein and des-gamma carboxyprothrombin levels declined to within the normal ranges. Hepatic and metastatic adrenal tumors, distant from the radiation field, exhibited a surprising regression. ZA is known to inhibit the activity of osteoclasts, bone-residential macrophages, and has been reported to have a direct anti-tumor effect. ZA may adjust the immunological milieu in tumor microenvironments by inhibiting the tumor-associated macrophages. Because radiotherapy can enhance the presentation of tumor-associated antigens, ZA and radiotherapy may exert synergistic anti-tumor effects.
一名72岁患有晚期肝细胞癌和丙型肝炎病毒相关性失代偿性肝硬化的男性患者发生了股骨转移瘤骨折。在接受放疗后，除了给予唑来膦酸（ZA）外，他仅接受了支持治疗。此后，最初升高的血清甲胎蛋白和异常凝血酶原水平降至正常范围。远离放射野的肝脏和肾上腺转移瘤出现了惊人的消退。已知ZA可抑制破骨细胞、骨驻留巨噬细胞的活性，并且据报道具有直接抗肿瘤作用。ZA可能通过抑制肿瘤相关巨噬细胞来调节肿瘤微环境中的免疫环境。由于放疗可增强肿瘤相关抗原的呈递，ZA与放疗可能发挥协同抗肿瘤作用。
