title: Complete remission of a case of hepatocellular carcinoma with tumor invasion in inferior vena cava and with pulmonary metastasis successfully treated with repeated arterial infusion chemotherapy.
abstract: We report the case of a patient having hepatocellular carcinoma with tumor invasion to the inferior vena cava and with multiple pulmonary metastases who was treated with repeated one-shot administration of epirubicin, cisplatin, and mitomycin C by hepatic artery and bronchial artery, which led to complete remission. A 72-year-old woman was diagnosed with infiltrative hepatocellular carcinoma with Vv3, multiple intrahepatic metastases, and multiple pulmonary metastases associated with compensated liver cirrhosis. One-shot infusion of epirubicin, cisplatin, and mitomycin C was performed through proper hepatic artery and bronchial artery for twice at eight weeks of intervals. Pulmonary metastases disappeared and intrahepatic lesions indicated marked shrinkage leaving a scar-like lesion with decreases in tumor markers. After six months and 20 months, tumor markers indicated increasing tendency but no evident recurrence was found by computed tomography or hepatic arteriography. One-shot infusion of the same regimens through proper hepatic artery was performed and tumor markers decreased to normal levels. After 14 months of the last therapy, no evidence of recurrence has been found on image analysis or in tumor markers. This arterial infusion therapy is well tolerated for the patients with compensated liver cirrhosis and might be promising for the effective treatment of advanced hepatocellular carcinoma with pulmonary metastases.
authors.affiliation: Division of Gastroenterology, Tohoku University School of Medicine, Aobaku Sendai City, 980-8574 Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kogure
authors.forename: Takao
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ueno
authors.forename: Noriatsu
authors.initials: N
authors.lastname: Kanno
authors.forename: Koji
authors.initials: K
authors.lastname: Fukushima
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yamagiwa
authors.forename: Futoshi
authors.initials: F
authors.lastname: Nagasaki
authors.forename: Eiji
authors.initials: E
authors.lastname: Kakazu
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Osamu
authors.initials: O
authors.lastname: Kido
authors.forename: Yu
authors.initials: Y
authors.lastname: Nakagome
authors.forename: Masashi
authors.initials: M
authors.lastname: Ninomiya
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001981:Bronchial Arteries; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D008175:Lung Neoplasms / Q000556:secondary*; D009361:Neoplasm Invasiveness; D012074:Remission Induction; D019233:Retreatment; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000473:pathology*