Hori Atsushi, Toei Hiroshi, Nakamura Tatsuya, Makitani Kazuhiro, Hori Shinichi
Institute for Image Guided Therapy, Department of Interventional Radiology, Izumisano, Japan.
Department of Radiology, Juntendo University, Tokyo, Japan.
BJR Case Rep. 2022 Feb 11;8(3):20210186. doi: 10.1259/bjrcr.20210186. eCollection 2022 Sep.
Intrahepatic cholangiocarcinoma is hardly diagnosed in early stages as the symptoms are non-specific. Due to an advanced stages at the time of first diagnosis, the therapeutic options for patients with unresectable cholangiocarcinoma are mostly limited to systemic chemotherapy or radiotherapy, but good local control or preferable prognostic effects are hardly obtained. The transarterial chemoembolization had not been a standard of care because of hepatic functional damages caused by lipiodol and gelatin sponge. A newly developed spherical embolic material causes limited hepatic damages might be an option for these patients. It makes it possible to repeat the procedure in a short period. Eventually, better prognosis can be expected using a spherical embolic material. We report a case of a 15 cm locally advanced intrahepatic cholangiocarcinoma treated by chemoembolization using a drug-eluting spherical embolic material and achieved good local tumor control without liver damage. The patient survived longer than 4 years without additional or concomitant treatments.
肝内胆管癌在早期很难被诊断出来，因为其症状不具有特异性。由于初次诊断时已处于晚期，无法切除的胆管癌患者的治疗选择大多局限于全身化疗或放疗，但很难获得良好的局部控制或较好的预后效果。由于碘油和明胶海绵会造成肝功能损害，经动脉化疗栓塞术一直不是标准的治疗方法。一种新开发的球形栓塞材料造成的肝损伤有限，可能是这些患者的一个选择。这使得在短时间内重复该操作成为可能。最终，使用球形栓塞材料有望获得更好的预后。我们报告一例15厘米局部晚期肝内胆管癌患者，采用载药球形栓塞材料进行化疗栓塞治疗，实现了良好的局部肿瘤控制且无肝损伤。该患者未经额外或联合治疗存活超过4年。
