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中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 28 -30. doi: 10.3877/cma.j.issn.1674-3946.2020.01.010

所属专题: 文献

论著

瑞戈非尼联合雷帕霉素成功治愈巨大肝癌肝移植术后弥漫双肺转移
李慧馨1, 杨占宇1, 李若凡1, 卢实春1, 吕文平1,()   
  1. 1. 100853 北京,解放军总医院第一医学中心肝胆外科
  • 收稿日期:2019-07-18 出版日期:2020-02-26
  • 通信作者: 吕文平

Regorafenib combined with sirolimus successfully cured diffuse double lung metastasis after liver transplantation for giant liver cancer

Huixin Li1, Zhanyu Yang1, Ruofan Li1, Shichun Lu1, Wenping Lv1,()   

  1. 1. Department of Hepatobiliary Surgery, the 1st Medical Center, PLA General Hospital, Beijing 100853, China
  • Received:2019-07-18 Published:2020-02-26
  • Corresponding author: Wenping Lv
  • About author:
    Corrsepongding author: Lyv Wenping, Email:
  • Supported by:
    National Nnatural Science Foundation of China(No.30772493)
引用本文:

李慧馨, 杨占宇, 李若凡, 卢实春, 吕文平. 瑞戈非尼联合雷帕霉素成功治愈巨大肝癌肝移植术后弥漫双肺转移[J]. 中华普外科手术学杂志(电子版), 2020, 14(01): 28-30.

Huixin Li, Zhanyu Yang, Ruofan Li, Shichun Lu, Wenping Lv. Regorafenib combined with sirolimus successfully cured diffuse double lung metastasis after liver transplantation for giant liver cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(01): 28-30.

目的

探讨瑞戈非尼联合雷帕霉素治疗超出移植标准的巨大肝癌肝移植术后弥漫双肺转移患者的疗效。

方法

观察1例瑞戈非尼联合雷帕霉素治疗超出移植标准(直径=18 cm, AFP>24 000 ng/ml)的肝细胞癌肝移植,术后弥漫双肺转移早期复发的病例。

结果

移植术后2个月出现弥漫双肺转移,治疗2个月后患者的双肺转移灶大部分消失,部分病灶较前明显缩小,治疗6个月后双肺转移灶完全消失,临床各项指标均降至正常范围,胸腹部CT及PET-CT均未见转移灶,达到临床痊愈。

结论

瑞戈非尼联合雷帕霉素可能会治愈巨大肝癌肝移植术后弥漫双肺转移的患者,其为拓宽肝移植适应证提供了一种可能的新手段。

Objective

To explore the efficacy of regorafenib combined with sirolimus in treating patients with diffuse double lung metastasis after liver transplantation for giant liver cancer beyond the Milan transplantation criteria.

Methods

Clinical observation was performed in a case of early diffuse bilateral lung metastasis after liver transplantation beyond the Milan transplantation criteria (diameter=18 cm, alpha-fetoprotein>24, 000 ng/ml), who was treated with regorafenib combined with sirolimus.

Results

Diffuse double lung metastasis occurred 2 months after transplantation. However, most of the metastasis disappeared, and some of the lesions were reduced in size after 2-months-treatment of regorafenib combined with sirolimus; and the pulmonary metastases in both lungs disappeared completely. The clinical indicators decreased to the normal range, no tumor metastasis was shown on chest, abdomen CT and PET-CT. The patient clinically recovered after 6 months of combined treatment.

Conclusion

Regorafenib combined with sirolimus could cure patients with diffuse double lung metastasis after liver transplantation for giant liver cancer, which would expand the indications for liver transplantation.

图1 肝癌患者移植术前肝脏肿瘤影像学
表1 1例肝癌患者肝移植术前及化疗前后肿瘤标志物和肝功能检验资料
图2 肝癌患者肝移植术后化疗前后双肺转移灶的变化
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