tailieunhanh - Báo cáo y học: " Abscopal effect of radiation on lung metastases of hepatocellular carcinoma: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Abscopal effect of radiation on lung metastases of hepatocellular carcinoma: a case report. | Okuma et al. Journal of Medical Case Reports 2011 5 111 http content 5 1 111 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Abscopal effect of radiation on lung metastases of hepatocellular carcinoma a case report Kae Okuma1 Hideomi Yamashita1 Yuzuru Niibe2 Kazushige Hayakawa2 Keiichi Nakagawa1 Abstract Introduction The abscopal effect is the effect of radiation therapy at a site distant to the area of irradiation. This is not a common event and has not been clearly defined resulting in few reported cases in the literature. We discuss this phenomenon in a patient with hepatocellular carcinoma. Case presentation A 63-year-old Japanese man underwent extended right hepatic lobectomy for hepatocellular carcinoma. During his follow-up examination a single lung metastasis and a single mediastinal lymph node metastasis were found. Trans-catheter arterial embolization was initially attempted to treat the mediastinal tumor however this approach failed to take effect and carried risks of spinal artery embolism. External-beam irradiation with a dose of Gy per fraction was performed using an antero-posterior parallel-opposed technique total dose Gy . A computed tomography scan performed one month after starting radiotherapy showed a remarkable reduction of the mediastinal lymph node metastasis. In addition to this we observed spontaneous shrinking of the lung metastasis which was located in the right lower lobe and out of the radiation field. No chemotherapy was given during the period. There has been no recurrence of either the lung metastasis or the mediastinal lymph node metastasis during a follow-up 10 years after the radiotherapy. Conclusion We observed a rare abscopal effect in a site distant from the area of irradiation. Irradiation of the mediastinum resulted in tumor mass regression in the untreated lung tumor. Introduction An abscopal effect has been defined as a reaction outside an irradiated area but within the same .