- 期刊
Sick Sinus Syndrome and Acute Tumor Lysis Syndrome after Low-dose Thalidomide Therapy in Recurrent Hepatocellular Carcinoma: A Case Report
以低劑量沙利竇邁(Thalidomide)治療肝癌併發竇性緩脈和急性腫瘤溶解症：一病例報告
摘要
沙利竇邁(thalidomide)已在臨床上用於肝癌末期患者，據文獻報告有3%-6%部份反應率和16%-31%患者可穩定病情，但也有20%患者因副作用而停藥，較嚴重副作用是有症狀之緩脈和急性腫瘤溶解症，有症狀之緩脈多好發於治療多發性骨髓瘤患者，發生率約1%-6%，未見於肝癌患者，而因使用沙利竇邁治療肝癌末期患者發生急性腫瘤溶解症僅有一例報告，在此，我們報告一例81歲肝癌末期患者只接受短期（15天）和低劑量（100mg/天）沙利竇邁治療後便產生嚴重竇性緩脈和急性腫瘤溶解症，本文提出在使用沙利竇邁治療肝癌患者初期應監測心跳，肝腎功能和電解質。
關鍵字
無資料並列摘要
Thalidomide has immunomodulatory and anti-angiogenic properties of potential value in anticancer therapy. The drug has been used in clinical trials for salvage treatment in advanced, unresectable hepatocellular carcinoma (HCC). These have been demonstrated that thalidomide has 3%-6% of partial response rate and stabilize the disease in 16-31% of HCC. Further, thalidomide treatment is generally tolerable, with side effects only necessitating cessation of therapy in 20% of cases. One of severe toxic effects is symptomatic bradycardia, mostly reported in therapy for multiple myeloma (MM) (1%-6%) but never in HCC. Tumor lysis syndrome (TLS) in treating both MM and HCC is an another life threatening complication that reported sporadically. Herein, we report a case involving sick sinus syndrome and acute tumor lysis syndrome after15 days of low-dose thalidomide therapy (100 mg/d). This case highlights the need for close monitoring of the signs and symptoms of bradycardia and electrolytes at the commencement of thalidomide therapy.
延伸閱讀
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