Effect of postoperative chemotherapy on the serum alpha-fetoprotein level in hepatoblastoma
Effect of postoperative chemotherapy on the serum alpha-fetoprotein level in hepatoblastoma
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DOI：
10.1016/j.jpedsurg.2004.08.038
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发表时间：
2004-12-01
影响因子：
2.4
通讯作者：
Saida, Y
中科院分区：
文献类型：
--
作者：
Kubota, M;Yagi, M;Saida, Y
目的：一般认为术后化疗对血清甲胎蛋白（AFP）水平无影响。作者报告了3例患者，他们在手术后表现出化疗相关的AFP水平变化。方法：本研究纳入3例肝母细胞瘤患者，其中1例为借口III型，2例为借口IV型。结果：1例托普ⅲ患者行肿瘤全切除，术后AFP水平下降至正常范围。然而，在连续3个疗程的化疗后，他始终表现出短暂的甲胎蛋白升高2- 3倍。由于药物性脑病不得不停止化疗方案，但随访5年无复发迹象，AFP水平也保持稳定，在正常范围内。两名接受根治性肿瘤切除术的托普IV患者也显示出类似的化疗相关AFP水平变化。这两个病例都是在术后常规化疗后才观察到的，而不是进一步的大剂量化疗。2例患者在停止化疗后17个月和7个月甲胎蛋白水平保持稳定。结论：对于肝母细胞瘤术后化疗，不仅要关注化疗过程中AFP的状态，也要关注AFP的绝对水平。(C) 2004爱思唯尔公司版权所有。
Purpose: It is generally accepted that postoperative chemotherapy does not affect the serum alpha-fetoprotein (AFP) level. The authors report on 3 patients who supposedly showed chemotherapy-related changes in their AFP levels after operation.Methods: This study included 3 patients with hepatoblastoma (1 case of PRETEXT III and 2 cases of PRETEXT IV).Results: One patient with PRETEXT III underwent a complete tumor resection, and the postoperative AFP level decreased until it reached the normal range. However, he consistently exhibited a transient, 2- to 3-fold increase in the AFP after each course of chemotherapy for 3 courses. The chemotherapy regimen had to be stopped because of drug-induced encephalopathy, but he has been followed up for 5 years without any evidence of recurrence, and his AFP level has also remained stable and in the normal range. Two patients with PRETEXT IV, who underwent a curative tumor resection, also showed similar chemotherapy-related changes in AFP levels. Both of these cases were observed only after the administration of routine postoperative chemotherapy instead of administering further high-dose chemotherapy. The AFP level remained stable for 17 months and 7 months after the cessation of chemotherapy in 2 cases, respectively.Conclusions: Regarding the postoperative chemotherapy of hepatoblastoma, we have to pay close attention to both the AFP status during chemotherapy as well as the absolute AFP level. (C) 2004 Elsevier Inc. All rights reserved.