多発性肺転移をともなった混合型肝癌に対してCDDP肝動注療法および全身化学療法GEM+CBDCA+5-FU/LVが奏功した1例

成正 村田, 美歩 田村, 馨 福永, 宗孝 森田, 勇三 平田, 洋也 飯田, 綾子 覚野, 隆之 西上, 若樹 山中
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引用次数: 4

Abstract

: This patient is a male in his 30's. He was diagnosed as hepatitis B virus-related huge primary liver cancer, 10cm in diameter, located in segment 4, accompanied with left portal thrombus and multiple lung metastases. Ten months after repeating systemic chemotherapy using gemcitabine (GEM)+carboplatin (CBDCA)+5-FU/leucovorin (LV) and hepatic arterial infusion chemotherapy with cisplatin (CDDP) 4 times, extended left lobectomy with caudate lobe could be successfully performed because of marked reducion of the huge tumor. The pathology revealed almost entirely necrotic changes of the main tumor, and the remaining, viable tumor nests showed combined hepatocellular and cholangiocarcinoma. Systemic chemotherapy was repeatedly given afterwards, which kept the pulmonary metastases stable without growth. The present case suggests that systemic chemotherapy using GEM+CBDCA+5-FU/LV may be useful in the multimodal treatment for the combined hepatocellular and cholangiocarcinoma with distant metastases.
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CDDP肝灌注疗法和全身化疗GEM+CBDCA+5-FU/LV对混合型肝癌的多发性肺转移奏效1例
例这位病人是一位30多岁的男性。诊断为乙型肝炎病毒相关性原发性巨大肝癌,直径10cm,位于4节段,伴左门静脉血栓及多发肺转移。经吉西他滨(GEM)+卡铂(CBDCA)+5-FU/亚叶酸素(LV)、顺铂(CDDP)肝动脉灌注化疗4次,重复全身化疗10个月后,因巨大肿瘤明显缩小,可成功行左侧尾状叶延长切除。病理显示主要肿瘤几乎完全坏死,剩余的活肿瘤巢显示肝细胞癌和胆管癌合并。随后反复给予全身化疗,使肺转移瘤保持稳定,无生长。本病例提示GEM+CBDCA+5-FU/LV的全身化疗可能有助于肝细胞癌和胆管癌合并远处转移的多模式治疗。
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