内容紹介
A Case of Resected Advanced Esophageal Cancer That Responded to Combination Therapy Comprising Docetaxel, Cisplatin, and 5-Fluorouracil
Summary
We report a case of resected advanced esophageal cancer that responded well to first-line combination therapy with docetaxel, cisplatin, and 5-fluorouracil(DCF therapy). A 72-year-old man was admitted to our hospital in January 2013 because of dysphagia. On the basis of the computed tomography(CT)and gastroendoscopy findings, he was diagnosed with advanced esophageal cancer with lymph node metastasis. The patient was treated with DCF therapy. After 2 courses of treatment, the primary tumor and lymph node metastasis were reduced on CT. After 3 courses of treatment, we performed subtotal esophagectomy and gastric tube reconstruction through the retroposterior mediastinal route. No residual cancer cells were found in the esophagus or lymph nodes. The patient subsequently received oral administration of tegafur-uracil alone for 24 months. The post-operative course was uneventful, and there was no detectable lymph node metastasis 42 months after the original diagnosis. Therefore, DCF therapy is a possible option for the management of advanced esophageal cancer.
要旨
症例は72歳,男性。嚥下困難を主訴に入院した。CT,食道透視および上部消化管内視鏡検査で,縦隔,腹部,傍大動脈リンパ節転移を伴うcT3N4M0,cStage Ⅳa食道癌と診断した。2013年1月よりdocetaxel/cisplatin/5-fluorouracil併用療法(DCF療法)を開始した。DCF療法2コース後のCTでは,原発巣およびリンパ節転移は縮小していた。DCF療法3コース後での食道透視および上部消化管内視鏡検査では,原発巣は著明に縮小していた。4月に食道亜全摘,胸骨後経路胃管再建術,胸部・腹部リンパ節郭清を行った。病理組織学的検査で下部食道全層に線維化と炎症細胞を認めたが,腫瘍細胞の残存はなく病理学的効果判定はGrade 3(pCR)と判定した。治療開始後42か月経過したが,再発なく生存している。DCF療法はリンパ節転移を伴う進行食道癌の治療として,放射線療法を温存し根治手術を可能とする有効な治療法であると考えられた。
目次
Summary
We report a case of resected advanced esophageal cancer that responded well to first-line combination therapy with docetaxel, cisplatin, and 5-fluorouracil(DCF therapy). A 72-year-old man was admitted to our hospital in January 2013 because of dysphagia. On the basis of the computed tomography(CT)and gastroendoscopy findings, he was diagnosed with advanced esophageal cancer with lymph node metastasis. The patient was treated with DCF therapy. After 2 courses of treatment, the primary tumor and lymph node metastasis were reduced on CT. After 3 courses of treatment, we performed subtotal esophagectomy and gastric tube reconstruction through the retroposterior mediastinal route. No residual cancer cells were found in the esophagus or lymph nodes. The patient subsequently received oral administration of tegafur-uracil alone for 24 months. The post-operative course was uneventful, and there was no detectable lymph node metastasis 42 months after the original diagnosis. Therefore, DCF therapy is a possible option for the management of advanced esophageal cancer.
要旨
症例は72歳,男性。嚥下困難を主訴に入院した。CT,食道透視および上部消化管内視鏡検査で,縦隔,腹部,傍大動脈リンパ節転移を伴うcT3N4M0,cStage Ⅳa食道癌と診断した。2013年1月よりdocetaxel/cisplatin/5-fluorouracil併用療法(DCF療法)を開始した。DCF療法2コース後のCTでは,原発巣およびリンパ節転移は縮小していた。DCF療法3コース後での食道透視および上部消化管内視鏡検査では,原発巣は著明に縮小していた。4月に食道亜全摘,胸骨後経路胃管再建術,胸部・腹部リンパ節郭清を行った。病理組織学的検査で下部食道全層に線維化と炎症細胞を認めたが,腫瘍細胞の残存はなく病理学的効果判定はGrade 3(pCR)と判定した。治療開始後42か月経過したが,再発なく生存している。DCF療法はリンパ節転移を伴う進行食道癌の治療として,放射線療法を温存し根治手術を可能とする有効な治療法であると考えられた。