PMC3617980_01
Liver function blood tests according to the patient's age. Bilirubin, ALT (alanine aminotransferase) and Alkaline ph (alkaline phosphatase) with units shown on left axis. Coagulation pp (prothrombin time) with units shown on right axis.
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F1
Bilirubin slowly normalised during the following year, while alkaline phosphatases stayed elevated at 1,000-1,500 U/l for several years, indicating a mild, long-term cholestasis (fig. 1).
PMC3617980_02
PMC3617980_03
Serum alpha-foetoprotein (alphaFP) measured during treatment. Treatment schedules indicated: C = cisplatin 100 mg/m2 in a 3-week cycle; GCT = gemcitabine (G) 1,000 mg/m2 day 1 and 8, cisplatin (C) 70 mg/m2 day 1, and docetaxel (Taxol , T) 175 mg/m2 day 1 in a 3-week cycle; S = sorafenib 400 mg p.o. b.i.d. reduced to 200 mg daily for 2 weeks after a 4-week break and then escalated to 400 mg daily; OG = oxaliplatin (O) 85 mg/m2, and gemcitabine (G) 1,000 mg/m2 every 2nd week; E = erlotinib p.o. 100 mg daily. Indicated below the x-axis are the results of tumour measurements by RECIST ver. 1.1. PR = Partial response; PD = progressive disease.
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F2
The patient's oncological treatment is summarised in figure 2 together with alphaFP values and the results of tumour evaluation by CT-scans.
CT scans at baseline (left) and after six series of chemotherapy (right), showing a major partial response with shrinkage of the primary liver tumour.
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F3
A further improvement in the patient's clinical condition was observed during this treatment, and its effect was confirmed by a major, partial response on the corresponding CT scans (fig. 3).