双侧乳腺癌伴严重肝功能障碍并发肝转移,通过调整紫杉醇剂量可继续化疗1例

Junya Hashizume, Megumi Matsumoto, H. Yano, R. Otsubo, Ayako Fukushima, Kayoko Sato, Hiroo Nakagawa, H. Harasawa, Tadahiro Nakamura, H. Sasaki, T. Nagayasu, Yukinobu Kodama
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摘要

多西紫杉醇和紫杉醇(PTX)是治疗人表皮生长因子受体2型(HER2)阳性转移/复发性乳腺癌的关键药物。然而,关于肝功能障碍的推荐剂量的信息很少。我们对her2阳性乳腺癌患者进行曲妥珠单抗/帕妥珠单抗/PTX联合治疗(50%剂量的PTX),这些患者由于多发性肝转移而患有Child-Pugh C肝功能障碍。化疗后患者肝功能迅速好转,故将PTX剂量增加至75%。然而,由于发热性中性粒细胞减少症(FN)的发生,PTX继续以50%的剂量。结果,患者能够在没有FN的情况下继续化疗。本病例将有助于我们考虑严重肝功能不全时PTX的给药方法。
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A Case of Bilateral Breast Cancer with Severe Liver Dysfunction Caused by Simultaneous Liver Metastasis in which Chemotherapy could be Continued by Adjusting the Paclitaxel Dose
Docetaxel and paclitaxel (PTX) are key drugs in human epidermal growth factor receptor type 2 (HER2) positive metastatic/recurrent breast cancer. However, there is little information on the recommended doses for liver dysfunction. We performed trastuzumab/pertuzumab/PTX combination therapy (50 % dose of PTX) for patients with HER2-positive breast cancer who had Child-Pugh C liver dysfunction due to multiple liver metastases. After the chemotherapy, the patient ʼ s liver function improved rapidly, so the dose of PTX was increased to 75 % . However, since febrile neutropenia (FN) occurred, PTX was continued at a dose of 50 % thereafter. As a result, the patient was able to continue chemotherapy without FN. This case will help us consider the administration method of PTX in the case of severe liver dysfunction.
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