Hepatic Artery Infusion Chemotherapy Sequential Hepatic Artery Embolization Combined with Operation in the Treatment of Recurrent Massive Hepatocellular Carcinoma Achieved Pathological Complete Response: A Case Report.

IF 1.8 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Pharmacogenomics & Personalized Medicine Pub Date : 2023-11-01 eCollection Date: 2023-01-01 DOI:10.2147/PGPM.S426791
Junjie Chen, Xiwen Liao, Yining Wu, Shenjian Ou, Wei Qin, Chengkun Yang, Yufeng Tan, Quan Lao, Minhao Peng, Tao Peng, Xinping Ye
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引用次数: 0

Abstract

Hepatocellular carcinoma (HCC) recurrence, which encompasses both true recurrence resulting from cancer spread and de novo tumors developing within the same cancer-prone liver, presents a complication in approximately 70% of cases within a 5-year timeframe. The efficacy of neoadjuvant therapy for recurrence after hepatectomy for hepatocellular carcinoma is still unclear. We report a case of recurrent massive advanced hepatocellular carcinoma with pathological complete remission was treated by continuous hepatic arterial infusion chemotherapy (HAIC) and sequential transcatheter arterial embolization (TAE) combined with secondary operation. One month after resection, the patient recurred (massive type 141mm×76mm). After 4 times of HAIC sequential TAE conversion therapy, the tumor shrank significantly (70mm×29mm), alpha-fetoprotein(AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels decreased significantly, residual liver volume[left half liver accounted for 39.85% of standard liver volume(left half liver + right anterior lobe) accounted for 80.17% of standard liver volume] and Indocyanine green 15-minute retention(ICG R15 8.0%) complies with surgical requirement.The second operation was performed, and the tumor was completely resected after hepatic blood flow occlusion Requirement. The postoperative pathological results showed complete remission (PCR) of the tumor, and no recurrence was found during the follow-up of 16 months. In this case, HAIC sequential TAE conversion therapy has good short-term effect on patients with postoperative recurrence of hepatocellular carcinoma, tumor burden is significantly reduced, the second surgery pathology achieves complete remission, safety and tolerance, it is worthy of study and promotion.

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肝动脉灌注化疗肝动脉栓塞联合手术治疗复发性大肝癌取得病理完全缓解1例报告。
肝细胞癌(HCC)复发,包括癌症扩散引起的真正复发和同一癌源肝脏内发展的新发肿瘤,在5年内约70%的病例出现并发症。肝细胞癌肝切除术后复发的新辅助治疗的疗效尚不清楚。我们报告了一例病理完全缓解的复发性大面积晚期肝细胞癌,采用连续肝动脉灌注化疗(HAIC)和连续经导管动脉栓塞(TAE)联合二次手术治疗。切除术后1个月,患者复发(肿块型141mm×76mm)。HAIC连续4次TAE转化治疗后肿瘤明显缩小(70mm×29mm),甲胎蛋白(AFP)和维生素K缺乏或拮抗剂II诱导的蛋白(PIVKA-II)水平显著下降,残余肝容量[左半肝占标准肝容量的39.85%(左半肝+右前叶)占标准肝体积的80.17%]和吲哚菁绿15分钟滞留(ICG R15 8.0%)符合手术要求。进行了第二次手术,在肝血流阻断要求后,肿瘤被完全切除。术后病理结果显示肿瘤完全缓解(PCR),随访16个月未发现复发。在这种情况下,HAIC序贯TAE转化治疗对肝细胞癌术后复发患者具有良好的短期疗效,肿瘤负担显著减轻,二次手术病理达到完全缓解,安全性和耐受性,值得研究和推广。
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来源期刊
Pharmacogenomics & Personalized Medicine
Pharmacogenomics & Personalized Medicine Biochemistry, Genetics and Molecular Biology-Molecular Medicine
CiteScore
3.30
自引率
5.30%
发文量
110
审稿时长
16 weeks
期刊介绍: Pharmacogenomics and Personalized Medicine is an international, peer-reviewed, open-access journal characterizing the influence of genotype on pharmacology leading to the development of personalized treatment programs and individualized drug selection for improved safety, efficacy and sustainability. In particular, emphasis will be given to: Genomic and proteomic profiling Genetics and drug metabolism Targeted drug identification and discovery Optimizing drug selection & dosage based on patient''s genetic profile Drug related morbidity & mortality intervention Advanced disease screening and targeted therapeutic intervention Genetic based vaccine development Patient satisfaction and preference Health economic evaluations Practical and organizational issues in the development and implementation of personalized medicine programs.
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