Park Jung Gil, Tak Won Young, Park Soo Young, Kweon Young Oh, Jang Se Young, Lee Soo Hyun, Lee Yu Rim, Jang Sun Kyung, Hur Keun, Lee Heon Ju
Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 41940, Republic of Korea.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41940, Republic of Korea.
Oncol Lett. 2017 Oct;14(4):4853-4856. doi: 10.3892/ol.2017.6788. Epub 2017 Aug 22.
Sorafenib is a tyrosine kinase inhibitor that has been demonstrated to improve the overall survival time of patients with advanced hepatocellular carcinoma (HCC). Although there have been a number of reports of patients achieving complete remission (CR) following sorafenib therapy, the long-term clinical outcomes of these patients have yet to be ascertained. A 72-year-old male patient with chronic hepatitis C, diabetes, hypertension and an old cerebral infarction was referred for the evaluation of a liver mass identified on an abdominal ultrasound. Abdominal computed tomography (CT) demonstrated a 13-cm mass replacing the right lobe of the liver, with portal vein thrombosis. HCC was confirmed by a percutaneous needle biopsy and treated with sorafenib. At 4 months, a follow-up CT demonstrated no enhancing viable lesions in the tumor and recanalization of the portal vein. Sorafenib therapy was continued for 48 months until the patient experienced dyspnea due to congestive heart failure, with pleural effusion. Following the discontinuation of sorafenib, the patient's symptoms improved. The patient followed up without recurrence for 52 months. Subsequent to achieving CR through treatment with sorafenib, long-term sorafenib therapy may be an option and efforts should be made to monitor cardiac toxicity during sorafenib therapy, particularly in high-risk patients.
索拉非尼是一种酪氨酸激酶抑制剂，已被证明可改善晚期肝细胞癌（HCC）患者的总生存时间。尽管已有多项关于患者在接受索拉非尼治疗后实现完全缓解（CR）的报道，但这些患者的长期临床结局尚未确定。一名72岁男性患者，患有慢性丙型肝炎、糖尿病、高血压和陈旧性脑梗死，因腹部超声检查发现肝脏肿物而前来评估。腹部计算机断层扫描（CT）显示一个13厘米的肿物取代了肝脏右叶，并伴有门静脉血栓形成。经皮穿刺活检确诊为HCC，并接受索拉非尼治疗。4个月时，随访CT显示肿瘤内无强化的存活病灶，门静脉再通。索拉非尼治疗持续了48个月，直到患者因充血性心力衰竭伴胸腔积液出现呼吸困难。停用索拉非尼后，患者症状改善。患者随访52个月无复发。在通过索拉非尼治疗实现CR后，长期索拉非尼治疗可能是一种选择，并且在索拉非尼治疗期间应努力监测心脏毒性，尤其是在高危患者中。
