肝臓
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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53 巻, 6 号
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  • 進行肝細胞癌患者に対する分子標的薬（ソラフェニブ）投与における治療効果判定基準の比較
    有住 忠晃, 上嶋 一臣, 竹田 治彦, 大崎 往夫, 萩原 智, 井上 達夫, 北井 聡, 矢田 典久, 櫻井 俊治, 西田 直生志, 工 ...
    2012 年 53 巻 6 号 p. 344-347
    発行日: 2012年
    公開日: 2012/07/04
    DOIhttps://doi.org/10.2957/kanzo.53.344
    ジャーナル フリー
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    Response Evaluation Criteria In Solid Tumor version 1.1 (RECIST1.1), modified RECIST (mRECIST) and Response Evaluation Criteria In Cancer of the Liver (RECICL) are frequently used as a response evaluation criteria for hepatocellular carcinoma. The overall survival (OS) of the patients treated with sorafenib was evaluated among these criteria respectively. In patients treated with sorafenib over 30 days, OS was stratified by RECICL and mRECIST, but not stratified by RECIST1.1. There was a statistically significant difference in RECICL (p=0.0133). In patients treated with sorafenib over 60 days, OS was also stratified by RECICL and mRECIST, but not stratified by RECIST1.1. There was also a statistically significant difference in the RECICL (p=0.0173). In patients with advanced hepatocellular carcinoma treated with sorafenib, evaluation of the tumor necrosis is considered very important and bidimensional measurement is necessary to measure viable area more precisely. RECICL which evaluates the tumor necrosis and includes bidimensional measurement may be considered the most useful criteria to predict the prognosis in the evaluation of treatment with sorafenib.
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  • 進行肝細胞癌に対するソラフェニブ投与例におけるSDの持続期間と生存期間の検討
    有住 忠晃, 上嶋 一臣, 早石 宗右, 田北 雅弘, 北井 聡, 井上 達夫, 矢田 典久, 萩原 智, 南 康範, 櫻井 俊治, 西田 ...
    2012 年 53 巻 6 号 p. 348-350
    発行日: 2012年
    公開日: 2012/07/04
    DOIhttps://doi.org/10.2957/kanzo.53.348
    ジャーナル フリー
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    【PURPOSE】 Sorafenib is a molecularly-targeted drug, which have been proven survival benefit for advanced hepatocellular carcinoma (HCC). Because of the unique side effects of sorafenib such as hand-foot skin reaction (HFSR), the administration of sorafenib is often discontinued. We compared the efficacy of overall survival (OS) in the view of the duration of stable disease (SD).
    【METHODS】 112 patients with advanced HCC have been treated with sorafenib in our hospital. They were evaluated the antitumor response according to the modified Response Evaluation Criteria in Solid Tumor. We compared the relationship between the duration of SD and OS.
    【RESULTS】 Complete response (CR) was observed in 2 patients, partial response (PR) in 16 patients, SD in 36 patients and progression disease (PD) in 27 patients, respectively. CR+PR patients (CR+PR group) had Child-Pugh A/B=18/0, BCLC stage A/B/C=3/6/9 and HBV/HCV/NBNC=6/8/4. SD patients (SD group) had Child-Pugh A/B=30/6, BCLC stage A/B/C=16/6/14 and HBV/HCV/NBNC=5/20/11. In the SD group the median duration of SD was 3.3 months. The SD group was divided into two groups; less than three months defined as Short SD and more than three months defined as Long SD. We compared the relationship of overall survival between the group of PR, Long SD, and Short SD. In the Short SD group, the median OS was 6.2 months (95%C.I. 4.7-7.3). In the Long SD group, the median OS was 17.6 months (95%C.I. 10.4-23.6). In the CR+PR Group, the median OS was 19.1 months (95%C.I. 14.2-23.8). There was not statistically significant difference between the OS of CR+PR group and the OS of Long SD group, however, there was statistically significant difference between the OS of Long SD group and the OS of Short SD group.
    【CONCLUSION】 In the treatment of sorafenib for advanced HCC, long duration of SD improves the OS as same as CR+PR. Controlling the unique side effects of sorafenib such as HFSR is important to obtain the longer treatment duration.
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  • ミリプラチン動注化学療法を併用したラジオ波凝固療法
    今井 則博, 池田 健次, 瀬古 裕也, 原 祐, 大野 敦司, 松本 直樹, 川村 祐介, 保坂 哲也, 小林 正宏, 斎藤 聡, 瀬崎 ...
    2012 年 53 巻 6 号 p. 351-354
    発行日: 2012年
    公開日: 2012/07/04
    DOIhttps://doi.org/10.2957/kanzo.53.351
    ジャーナル フリー
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    Miriplatin is a platinum complex developed to treat hepatocellular carcinoma (HCC) via administration into the hepatic artery as a sustained-release suspension in iodized oil. We retrospectively evaluated the efficacy of combination therapy with transcatheter arterial infusion chemotherapy using miriplatin and percutaneous radiofrequency ablation for HCC in 11 patients. Immediately after transcatheter arterial infusion chemotherapy using miriplatin, we performed radiofrequency ablation. The greatest long-axis and short-axis dimensions of the area coagulated after combination therapy were 42 mm (35-80 mm) and 34 mm (32-60 mm), respectively. During follow-up (median 12 months), there was no recurrence from the same subsegment. No serious adverse events were observed. These results suggested that using the combination therapy, it is possible to finish one treatment session for patient with HCC.
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