肝细胞癌伴Ⅳ型门静脉癌栓患者经局部及靶向治疗完全缓解1例

A case of complete remission of hepatocellular carcinoma with type portal vein tumor thrombus by local and targeted therapy

肝细胞癌(hepatocellular carcinoma,HCC)合并门静脉癌栓(portal vein tumor thrombus,PVTT),尤其是Ⅳ型癌栓者难治疗、预后差。本文报道1例初诊确诊为HCC合并Ⅲ型PVTT患者,经肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)1次+射频消融治疗(radiofrequency ablation,RFA)1次+索拉非尼(400 mg,每日2次)治疗1个月后进展为HCC合并Ⅳ型癌栓,经乐伐替尼(12 mg,每日1次)治疗1个月达肿瘤降期,再次联合TACE治疗1次+RFA治疗1次,肿瘤评估完全缓解(complete remission,CR)。

Patients of hepatocellular carcinoma(HCC)with portal vein tumor thrombus(PVTT),especially those with type Ⅳ PVTT were difficult to treat and the prognosis was poor.This paper reported a newly diagnosed case of HCC with type Ⅲ PVTT,who was treated by transcatheter arterial chemoembolization(TACE)one time + radiofrequency ablation(RFA)one time + sorafenib(400 mg,twice per day)for one month,then the case progressed to type Ⅳ PVTT and received lenvatinib(12 mg,once per day)for one month,and the stage of tumor descended.The patient received TACE(one time)+ RFA(one time)again,and the tumor assessment reached complete remission(CR).