Dramatic improvement after palliative whole-liver radiotherapy for liver damage caused by diffuse liver metastases from castration-resistant prostate cancer: A case report
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Published:2023-01-17
Issue:1
Volume:8
Page:5-9
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ISSN:
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Container-title:Journal of Case Reports and Images in Urology
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language:en
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Short-container-title:J Case Rep Images Urol
Author:
Ogoshi Yumi1, Ito Kei1, Nemoto Murofushi Keiko1, Ito Masaya2, Kobayashi Shuichiro2, Koga Fumitaka2
Affiliation:
1. Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan 2. Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
Abstract
Introduction: Whole-liver radiotherapy (WLRT) is performed for palliative purposes in patients with metastatic liver tumors. However, it remains unclear whether the benefits obtained from WLRT surpass the potential disadvantages of radiotherapy-induced liver disease in such patients, particularly those with severe liver damage. We present the case of a 76-year-old man with diffuse liver metastases from castration-resistant prostate cancer.
Case Report: He was diagnosed as having prostate cancer with multiple metastases to the bone, pleura, and para-aortic lymph nodes three years and six months earlier and developed hepatic metastases following a sequence of therapies, including surgical castration, bicalutamide, enzalutamide, and 10 cycles of docetaxel. Despite administering abiraterone acetate for two months, the prostate-specific antigen (PSA) levels increased, and the patient developed symptomatic liver damage, presenting with jaundice, anorexia, and fatigue. His serum total bilirubin (9.5 mg/dL) and liver transaminase (>100 U/L) levels were markedly elevated. The patient received WLRT at 8 Gy in a single fraction for palliative intent. Symptomatic relief was achieved shortly after WLRT, and the total bilirubin and transaminase levels decreased and normalized within two months. Additionally, two months after WLRT, the PSA level decreased from 285 to 23.3 ng/mL, and a robust partial tumor response was observed on computed tomography images. Although the patient died of cancer eight months after WLRT, radiotherapy-induced liver disease was not confirmed during the follow-up period.
Conclusion: In the present case, WLRT successfully relieved the symptoms and reversed the liver damage caused by diffuse metastases, and it was considered to contribute to cancer control without adverse events. Thus, WLRT can be a viable option for patients with liver damage induced by diffuse liver metastases.
Publisher
Edorium Journals Pvt. Ltd.
Subject
Strategy and Management,Economics and Econometrics,Finance,Business and International Management,General Economics, Econometrics and Finance,Mechanical Engineering,Mechanics of Materials,Condensed Matter Physics,General Materials Science,Immunology,Immunology and Allergy,Rheumatology,Strategy and Management,Finance,Economics and Econometrics,Finance,Accounting,Economics and Econometrics,Finance,Accounting,Finance,Strategy and Management,General Social Sciences,General Engineering,Safety, Risk, Reliability and Quality,Health Informatics,Surgery
Reference10 articles.
1. Loriot Y, Fizazi K, de Bono JS, Forer D, Hirmand M, Scher HI. Enzalutamide in castration-resistant prostate cancer patients with visceral disease in the liver and/or lung: Outcomes from the randomized controlled phase 3 AFFIRM trial. Cancer 2017;123(2):253–62. 2. Halabi S, Kelly WK, Ma H, et al. Meta-analysis evaluating the impact of site of metastasis on overall survival in men with castration-resistant prostate cancer. J Clin Oncol 2016;34(14):1652–9. 3. Bydder S, Spry NA, Christie DR, et al. A prospective trial of short-fractionation radiotherapy for the palliation of liver metastases. Australas Radiol 2003;47(3):284–8. 4. Ito K, Osawa Y, Shimizuguchi T, et al. Whole-liver radiotherapy for diffuse liver metastases improves liver enzymes and related factors. Acta Oncol 2019;58(4):512–4. 5. Soliman H, Ringash J, Jiang H, et al. Phase II trial of palliative radiotherapy for hepatocellular carcinoma and liver metastases. J Clin Oncol 2019;31(4):3980–6.
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