@article{oai:shiga-med.repo.nii.ac.jp:00003818,
 author = {OSAKI, Rie and IIDA, Hiroya and NODA, Satoshi and FUJIMOTO, Takehide and WAKASUGI, Yoshinori and TERADA, Tomohiro and TANI, Masaji and ANDOH, Akira and 大崎, 理英 and 飯田, 洋也 and 野田, 哲史 and 藤本, 剛英 and 若杉, 吉宣 and 寺田, 智祐 and 谷, 眞至 and 安藤, 朗},
 issue = {2},
 journal = {肝臓, Acta Hepatologica Japonica},
 month = {Feb},
 note = {症例は慢性C 型肝炎に罹患し飲酒習慣もある60 歳代男性で，原発性肝細胞癌の一部に破裂予防の肝動脈塞栓術施行後，lenvatinib 8 mg/日を開始した．約1 カ月で腫瘍に感染し，抗生剤治療不応かつ経皮的ドレナージ困難にて，lenvatinib を一週間休薬し，開腹下感染腫瘍切除術を施行した．術後創部治癒に問題なく，lenvatinib を4 mg/日で再開したが，肝障害，倦怠感，食思不振で35 日間休薬した．dexamethasone 併用して再開し，8 mg/日まで増量したが動脈血流減少せず，lenvatinib 血中濃度が低値であった．12 mg/日に増量後，有害事象なしに血中濃度
は上昇し，動脈血流も低下した．腫瘍感染の治療困難例は耐術能が許せば，lenvatinib の適切な休薬で外科的治療も選択でき，また，lenvatinib 血中濃度による投与量の調整は有効な可能性がある．, A 60-year-old man was diagnosed with hepatocellular carcinoma (HCC). He had hepatitis C virus infection, type 1 diabetes, and alcoholic liver injury as comorbidities. Owing to the risk of rupture of the HCCs that we feared, we performed transcatheter arterial embolization before initiating lenvatinib administration at 8 mg/day (55 kg). One month later, the HCCs became infected. He required surgery owing to insufficient antiviral efficacy. Lenvatinib administration was then restarted at 4 mg/day. He developed liver dysfunction, nausea, and anorexia, all of which resolved after lenvatinib cessation for 35 days and dexamethasone administration. As the current blood lenvatinib levels were lower than those at the start of administration, we increased the dose to 12 mg/day, thereby reducing the arterial blood supply to the HCC. This case suggests the effectiveness of surgery in the treatment of infected HCCs after the cessation of lenvatinib administration, and the usefulness of blood lenvatinib levels measurement for determining appropriate dosages., Journal Article},
 pages = {80--88},
 title = {多発肝細胞癌に対するLenvatinibの治療継続に肝切除と血中濃度測定が有用であった一例},
 volume = {62},
 year = {2021}
}