内容紹介
Two Patients with Recurrence of Hepatocellular Carcinoma after Liver Resection Who Achieved Long-Term Stable Disease with Small Doses of Sorafenib Therapy
Summary
Case 1: A 64-year-old man with hepatocellular carcinoma(HCC)had received local therapy repeatedly for 20 years. In 2012, he underwent hepatic right lobectomy for recurrence of HCC. Multiple recurrences were found in the hepatic remnant, and transcatheter arterial chemoembolization(TACE)was performed. Considering his condition, a small dose of sorafenib(200 mg per day)was administered. He complained of general fatigue, so we prolonged the administration interval(200 mg every other day). Thereafter, compliance improved and long-term stable disease(long SD), for more than 6 months, long SD was achieved. Case 2: A 75-year-old man with HCC was treated by TACE repeatedly for multiple recurrences after liver resection(segment 6). In 2008, metastases to the thoracic vertebra and left rib were treated by radiation therapy and radiofrequency ablation, respectively. Subsequently, sorafenib(400 mg per day)was administered. We reduced the dose of sorafenib to less than 400 mg per day because of diarrhea, hypertension, and general fatigue. Thereafter, long SD was achieved despite the small dose of sorafenib. We report here 2 cases of HCC where we achieved long SD in spite of treating with a small dose of sorafenib.
要旨
症例1: 64歳,男性。C型慢性肝炎からの肝細胞癌(hepatocellular carcinoma: HCC)に対して局所治療反復後,肝右葉の3か所のHCCに対して2012年4月に肝右葉切除を行った。残肝多発再発に対して肝動脈化学塞栓療法(transcatheter arterial chemoembolization: TACE)施行後,腫瘍増大に対し11月からsorafenib 200 mg/dayを開始した。200 mg/dayと少量にもかかわらず全身倦怠感が強く200 mg隔日投与に変更したところ,投与継続が可能となり長期間(6か月以上)のstable disease(long-term stable disease: long SD)となった。症例2: 75歳,男性。HCCのため肝S6切除後に肝右葉に多発再発。TACEを繰り返していた。2008年1月胸椎転移に対して放射線療法,12月に左肋骨転移に対してラジオ波凝固療法(radiofrequency ablation: RFA)を行った後sorafenib 400 mg/dayを開始した。下痢,高血圧,全身倦怠感などで400 mg/dayを維持できず,減量,中断を繰り返しながらもsorafenibの少量投与(200 mg/day以下)を継続した結果,long SDが得られた。HCC術後再発に対して少量のsorafenibを用いてlong SDとなった2症例を経験した。
目次
Summary
Case 1: A 64-year-old man with hepatocellular carcinoma(HCC)had received local therapy repeatedly for 20 years. In 2012, he underwent hepatic right lobectomy for recurrence of HCC. Multiple recurrences were found in the hepatic remnant, and transcatheter arterial chemoembolization(TACE)was performed. Considering his condition, a small dose of sorafenib(200 mg per day)was administered. He complained of general fatigue, so we prolonged the administration interval(200 mg every other day). Thereafter, compliance improved and long-term stable disease(long SD), for more than 6 months, long SD was achieved. Case 2: A 75-year-old man with HCC was treated by TACE repeatedly for multiple recurrences after liver resection(segment 6). In 2008, metastases to the thoracic vertebra and left rib were treated by radiation therapy and radiofrequency ablation, respectively. Subsequently, sorafenib(400 mg per day)was administered. We reduced the dose of sorafenib to less than 400 mg per day because of diarrhea, hypertension, and general fatigue. Thereafter, long SD was achieved despite the small dose of sorafenib. We report here 2 cases of HCC where we achieved long SD in spite of treating with a small dose of sorafenib.
要旨
症例1: 64歳,男性。C型慢性肝炎からの肝細胞癌(hepatocellular carcinoma: HCC)に対して局所治療反復後,肝右葉の3か所のHCCに対して2012年4月に肝右葉切除を行った。残肝多発再発に対して肝動脈化学塞栓療法(transcatheter arterial chemoembolization: TACE)施行後,腫瘍増大に対し11月からsorafenib 200 mg/dayを開始した。200 mg/dayと少量にもかかわらず全身倦怠感が強く200 mg隔日投与に変更したところ,投与継続が可能となり長期間(6か月以上)のstable disease(long-term stable disease: long SD)となった。症例2: 75歳,男性。HCCのため肝S6切除後に肝右葉に多発再発。TACEを繰り返していた。2008年1月胸椎転移に対して放射線療法,12月に左肋骨転移に対してラジオ波凝固療法(radiofrequency ablation: RFA)を行った後sorafenib 400 mg/dayを開始した。下痢,高血圧,全身倦怠感などで400 mg/dayを維持できず,減量,中断を繰り返しながらもsorafenibの少量投与(200 mg/day以下)を継続した結果,long SDが得られた。HCC術後再発に対して少量のsorafenibを用いてlong SDとなった2症例を経験した。