Two Cases of Hepatocellular Carcinoma Presented Rapid Progression of Lung Metastatic Lesions after Interruption of the Continuous Infusion Therapy of Recombinant Interleukin 2 with Single-shot Injection of Adriamycin and Lipiodol

Two patients with hepatocellular carcinoma had received continuous infusion of recombinant interleukin 2 (r-IL2) and intermittent single injections of adriamycin (ADR) and lipiodol had maintained good performanse statuses despite increases in AFP until abrupt cessation of the r-IL2 administration. After that, rapid progression of lung metastatic lesions occurred. Before immunochemotherapy was started in Case 1, a main tumor, stage III, 9 cm in diameter, and its surrounding small tumors in the caudate lobe were resected by left lobectomy and caudate lobectomy. In Case 2 a tumor, 2.5 cm in diameter, in the posterior segment was not resected but only transcatheter arterial embolization was performed because of severe liver cirrhosis (clinical stage III). In both cases despite the absence of tumors detectable by CT, AFP levels continued to increase. After cessation of the treatment because of a common cold in Case 1 and rupture of esophageal varices in Case 2, lung metastatic lesions rapidly became larger within a week, and patients died of respiratory failure in the 3rd and 4th week, respectively after the treatment was stopped. Changes in NK and LAK activities and the presence of IL2 receptor positive subset in the peripheral lymphocytes led to the suspicion that a kind of rebound-like phenomenon occurred in the lung metastatic lesions after the discontinuance of the long term infusion of r-IL2.