Daiku Kazuma, Nishio Akira, Hikita Hayato, Doi Akira, Hayashi Kazuhiko, Kato Seiya, Sasaki Yoichi, Shimoda Akiyoshi, Kudo Shinnosuke, Fukumoto Kenji, Maesaka Kazuki, Matsumae Takayuki, Shirai Kumiko, Sato Katsuhiko, Murai Kazuhiro, Tahata Yuki, Yoshioka Teppei, Furuta Kunimaro, Kodama Takahiro, Tatsumi Tomohide, Ogawa Kazuhiko, Takehara Tetsuo
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Japan.
Gastro Hep Adv. 2025 Feb 1;4(5):100634. doi: 10.1016/j.gastha.2025.100634. eCollection 2025.
A 66-year-old male with advanced hepatocellular carcinoma, including the portal vein and inferior vena cava tumor thrombi extending to right atrium, received Atezolizumab/Bevacizumab and radiotherapy. In the first 2 weeks, he exhibited fever, elevated C-reactive protein and lactate dehydrogenase levels, and intratumoral bleeding, indicating an antitumor immune response. He achieved a complete response by week 6, maintained until week 89, despite grade 3 pneumonitis and grade 2 proteinuria. This case demonstrates that combining radiotherapy and immunotherapy can be an effective and tolerable treatment for advanced hepatocellular carcinoma with macrovascular invasion, though further studies are needed to confirm the safety and efficacy of this strategy.
一名66岁男性患有晚期肝细胞癌，包括门静脉和下腔静脉瘤栓延伸至右心房，接受了阿替利珠单抗/贝伐单抗和放射治疗。在最初的2周内，他出现发热、C反应蛋白和乳酸脱氢酶水平升高以及肿瘤内出血，提示抗肿瘤免疫反应。尽管出现3级肺炎和2级蛋白尿，但他在第6周时达到完全缓解，并维持至第89周。该病例表明，放疗和免疫治疗联合应用对于伴有大血管侵犯的晚期肝细胞癌可能是一种有效且可耐受的治疗方法，不过仍需进一步研究来证实该策略的安全性和有效性。
