title: [Combination Chemotherapy Using Sorafenib and Hepatic Arterial Infusion with a Fine-Powder Formulation of Cisplatin for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis--A Case Report].
abstract: Sorafenib has been a standard therapy for advanced hepatocellular carcinoma (HCC) with portal vein thrombosis. Hepatic arterial infusion chemotherapy (HAIC) is still preferably performed in Japan because of its relatively good tumor-shrinking effect. We report a case of advanced multiple HCC with portal thrombus that responded to combination chemotherapy with sorafenib and repeat hepatic arterial infusion with a fine-powder formulation of cisplatin (IA-call®). A 57-year-old man presented for the treatment of HCC with alcoholic cirrhosis. Multiple HCC were found to be rapidly progressing with portal thrombosis. HAIC with IA-call® was performed, but the tumors progressed. TAE was performed 3 times thereafter and the main tumor shrunk to some extent. A month after the last TAE, the HCC was found to progress again, and oral sorafenib was administered. A reservoir and catheter were placed and HAIC with low-dose 5-fluorouracil and cisplatin was performed for 3 cycles following 1 HAIC cycle with epirubicin and mitomycin C, which was not effective. For 10 months after initial therapy, HAIC using IA-call® has been performed once for 6 weeks. After performing HAIC with IA-call® 5 times, the serum levels of HCC tumor markers AFP and PIVKA-Ⅱdecreased, and the tumors continued to shrink and were not stained on enhanced CT scan. The patient has been alive for 23 months after the initial therapy and has maintained stable disease.
authors.affiliation: Dept. of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Akishige
authors.initials: A
authors.lastname: Kanazawa
authors.forename: Sadatoshi
authors.initials: S
authors.lastname: Shimizu
authors.forename: Akihiro
authors.initials: A
authors.lastname: Murata
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sakae
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Kurihara
authors.forename: Tetsuzo
authors.initials: T
authors.lastname: Tashima
authors.forename: Sota
authors.initials: S
authors.lastname: Deguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakai
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Kioka
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D004621:Embolization, Therapeutic; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000008:administration & dosage; D011169:Portal Vein / Q000473:pathology*; D011208:Powders; D000077157:Sorafenib; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy*
chemical_list: D010671:Phenylurea Compounds; D011208:Powders; D009536:Niacinamide; D000077157:Sorafenib; D002945:Cisplatin