Dramatic improvement after palliative whole-liver radiotherapy for liver damage caused by diffuse liver metastases from castration-resistant prostate cancer: A case report

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

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