内容紹介
A Case of Perianal Squamous Cell Carcinoma with Left Inguinal Lymph Node Metastasis That Showed a Complete Response More Than Five Years after Chemotherapy and Concomitant Proton Beam Therapy
Summary
We report a case of perianal squamous cell carcinoma and left inguinal lymph node metastasis that showed a complete response more than 5 years after chemotherapy and concomitant proton beam therapy. A 34-year-old woman was referred to our hospital for an anal tumor and a left inguinal tumor. A digital rectal examination revealed a tumor in the anterior wall of the anal canal. In addition, the left inguinal lymph nodes were swollen, leading us to suspect metastases. Biopsy specimens confirmed poorly differentiated squamous cell carcinoma. We made a diagnosis of squamous cell carcinoma T4bN2M0, StageⅢb. The patient was treated with chemotherapy consisting of 5-FU(700 mg/m2/day; continuous intravenous administration)on days 1-5, and CDDP(70 mg/m2/day)on day 1, along with concomitant proton beam therapy. A total of 45 Gy of X-ray irradiation was administered to the primary lesion, pelvis, and groin area. Furthermore, 24.2 Gy of proton beam therapy was administered to the primary lesion, and 28.6 Gy to the left inguinal lymph nodes. The patient tolerated this treatment with no severe adverse effects. The tumor disappeared completely 1 month after this treatment, and biopsy specimens confirmed the absence of any viable cancer cells. The patient has been alive with no sign of recurrence for 5 years.
要旨
鼠径部リンパ節転移を伴う肛門扁平上皮癌に対して同時化学療法併用陽子線治療が著効し,5年以上complete response(CR)を得た症例を経験した。症例は34歳,女性。3か月前からの左鼠径部のしこり,肛門腫瘤を主訴に近医より紹介受診した。左鼠径部リンパ節腫脹と2時を中心とした膣浸潤を認める2型の肛門腫瘍を認め,生検で扁平上皮癌と診断された。T4bN2M0,StageⅢbの肛門扁平上皮癌に対し,同時化学療法併用陽子線治療を行った。化学療法は5-FU(700 mg/m2/day,day 1～5)の持続静注とCDDP(70 mg/m2/day,day 1)の併用とし,陽子線治療はX線による全骨盤予防照射45 Gy/25回の後,陽子線を主病巣に24.2 Gy/11回,左鼠径部リンパ節に28.6 Gy/13回照射した。陽子線治療が終了し,1か月後には腫瘍および鼠径部リンパ節は消失した。治療開始後5年が経過し,現在も無再発生存中である。
目次
Summary
We report a case of perianal squamous cell carcinoma and left inguinal lymph node metastasis that showed a complete response more than 5 years after chemotherapy and concomitant proton beam therapy. A 34-year-old woman was referred to our hospital for an anal tumor and a left inguinal tumor. A digital rectal examination revealed a tumor in the anterior wall of the anal canal. In addition, the left inguinal lymph nodes were swollen, leading us to suspect metastases. Biopsy specimens confirmed poorly differentiated squamous cell carcinoma. We made a diagnosis of squamous cell carcinoma T4bN2M0, StageⅢb. The patient was treated with chemotherapy consisting of 5-FU(700 mg/m2/day; continuous intravenous administration)on days 1-5, and CDDP(70 mg/m2/day)on day 1, along with concomitant proton beam therapy. A total of 45 Gy of X-ray irradiation was administered to the primary lesion, pelvis, and groin area. Furthermore, 24.2 Gy of proton beam therapy was administered to the primary lesion, and 28.6 Gy to the left inguinal lymph nodes. The patient tolerated this treatment with no severe adverse effects. The tumor disappeared completely 1 month after this treatment, and biopsy specimens confirmed the absence of any viable cancer cells. The patient has been alive with no sign of recurrence for 5 years.
要旨
鼠径部リンパ節転移を伴う肛門扁平上皮癌に対して同時化学療法併用陽子線治療が著効し,5年以上complete response(CR)を得た症例を経験した。症例は34歳,女性。3か月前からの左鼠径部のしこり,肛門腫瘤を主訴に近医より紹介受診した。左鼠径部リンパ節腫脹と2時を中心とした膣浸潤を認める2型の肛門腫瘍を認め,生検で扁平上皮癌と診断された。T4bN2M0,StageⅢbの肛門扁平上皮癌に対し,同時化学療法併用陽子線治療を行った。化学療法は5-FU(700 mg/m2/day,day 1～5)の持続静注とCDDP(70 mg/m2/day,day 1)の併用とし,陽子線治療はX線による全骨盤予防照射45 Gy/25回の後,陽子線を主病巣に24.2 Gy/11回,左鼠径部リンパ節に28.6 Gy/13回照射した。陽子線治療が終了し,1か月後には腫瘍および鼠径部リンパ節は消失した。治療開始後5年が経過し,現在も無再発生存中である。