Abstract
We report a 75-year-old woman with advanced hepatocellular carcinoma (HCC) with portal vein main trunk tumor thrombosis treated successfully by repeated hepatic arterial infusion chemotherapy (HAIC). She had been diagnosed with hepatitis B virus cirrhosis since 1998 and followed up by a local practitioner. As hepatocellular carcinoma occurrence was suspected on abdominal computed tomography in March 2007, she was referred to our hospital. Although transcatheter arterial chemoembolization (TACE) with emulsion of epirubicin and lipiodol was performed twice, the therapeutic response was poor and temporary. Serum alpha-fetoprotein (AFP) level was elevated, and portal vein tumor thrombosis (PVTT) involving main trunk of portal vein (Vp4) appeared. In January 2008, the treatment was changed to hepatic arterial infusion chemotherapy (HAIC) with a fine-powder formulation of cisplatin (IA-call®). Immediately after HAIC, there was a significant decrease in AFP levels, and we estimated that IA-call® was effective. An arterial infusion reservoir was placed in the right hepatic artery in March 2008, and repeated HAIC of IA-call® was performed 7 times until December 2008. During this period, HCC with PVTT disappeared, and AFP level decreased to normal range. We judged complete remission was obtained, and it persisted for 7 years and 8 months after terminating HAIC. In July 2016, although recurrence was observed, it was controlled by repeated TACE, and she is alive as of December 2020. We encountered a case of advanced HCC with Vp4 who survived for over 13 years owing to the remarkable effect of repeated HAIC of IA-call®.
