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Vol.63 No.7 contents | Japanese/English |
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- Case Report -
A Case of Treatment-resistant Extensive-disease Small-cell Lung Cancer with Multiple Liver Metastases Shrunk by Whole Liver Radiotherapy
Shuji Kodama1, Masamichi Yoshida1, Hiroto Miki1, Hiroki Goto1, Kazuki Masuda1, Atsushi Fujiwara1, Yui Nanpei2, Naoko Sanuki2, Daiki Goto3, Tatsuki Tsuruga41Department of Respiratory Medicine, 2Department of Radiation Oncology, Mie Prefectural General Medical Center, Japan, 3Department of Internal Medicine, Minamiise Hospital, Japan, 4Department of Pulmonary Medicine, Mie University, Japan
Background. Liver metastases are common in patients with small-cell lung cancer (SCLC) and are associated with a poor prognosis. Recent reports, mainly from abroad, have demonstrated the efficacy of palliative radiotherapy for liver metastases, but this therapy has not been widely used or reported in Japan. Case. Since late June, 20XX-1, a 76-year-old man had been treated with carboplatin, etoposide, and durvalumab for extensive-disease SCLC. After completing six treatment cycles, the patient was undergoing maintenance therapy with durvalumab. Owing to worsening of the primary lesion, liver metastases, and para-aortic lymph node metastases, the patient was admitted to our hospital on late February, 20XX, for treatment modification. Since more than 90 days had passed since the last dose of etoposide, a sensitive relapse was considered, and carboplatin plus etoposide therapy was initiated. However, back pain and jaundice appeared and became severe, requiring the initiation of regular opioid therapy. The symptoms were suggestive of capsular extension due to the rapid growth of multiple liver metastases, prompting whole liver radiotherapy (21 Gy/7 fr) to alleviate pain. There was a temporary increase in pain due to a flare reaction, requiring a temporary increase in opioid and steroid doses, but the symptoms rapidly resolved, and the patient was discharged with independent gait. The patient was subsequently readmitted and switched to amrubicin therapy. Approximately one month after whole liver radiotherapy, all symptoms and multiple liver metastases were under control. Conclusion. SCLC is radiosensitive and responds well to low-dose radiotherapy. Radiation-induced liver disease is unlikely to occur at low doses, and whole liver radiotherapy is considered effective even in patients with treatment-resistant SCLC.
key words: Whole liver radiotherapy, Palliative radiotherapy, Extensive-disease small cell lung cancer, Liver metastasis, Treatment-resistant
Received: May 22, 2023
Accepted: August 9, 2023
JJLC 63 (7): 959-964, 2023
