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

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

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>24000 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.