肝切除後の残肝再発，多発肺転移に対しUFTが著効した 原発性肝細胞癌の1例

摘要

UFTはtegafurとuracilとを1：4のモル比に配合した抗癌剤で腫瘍内の5－FU濃度を高めるため，高い抗腫瘍効果を示す。症例は55歳の男性。 右季肋部痛を主訴に来院した。 肝前区域の巨大な肝細胞癌と診断され，肝拡大前区域切除術を施行した。 術後3か月で，AFP，PIVKA－ⅠⅠの急激な上昇および術後肝再発，多発肺転移を認めた。 外科的切除を断念し，UFT（300mg′day）投与を開始した。 UFT投与開始3か月後，残肝再発，肺転移巣は消失し，AFP，PIVKAMⅠⅠも正常化した。 UFT内服による副作用もなく，全身状態は極めて良好であり，CRと判定後4か月現在，UFT内服継続にて再発徴候もない。肺転移を伴う切除不能な肝細胞癌患者に対してUFT投与の有効性が示唆された.UFT is an anti-cancer drug which combines uracil with tegafur at a mole rate of 1 : 4, and shows a high anti-tumor effect by raising the 5-FLJ level in a tumor, A 55-year-old man with hypochondriac pain was admitted to Shinshu University Hospital The preoperative diagnosis was giant hepatocellular carcinoma (HCC) of the right hepatic anterior region, and extended anterior segmentectomy of the liver was performed, Three months later, serum alpha-fetoprotein (AFP) and PIVKA-II were elevated markedly, and computed tomography (CT) and magnetic resonance imaging (MRI) revealed a recurrence in the remnant liver and multiple lung metastasis. Chemotherapy with oral UFT (300 mg/day) administration alone was started for the unresectable HCC, Three months later, CT and MRI showed complete disappearance of the recurrent HCC and multiple lung metastasis,. Also, the titers of AFP and PIVKA-II were reduced to normal levels. This case suggests that oral UFT administration is a safe and effective therapy for postoperative HCC, even With lung metastasis