内容紹介
A Case of Resected Superior Sulcus Tumor with Pathological Complete Response after Trimodality Therapy
Summary
The current case was 73-year-old woman. She was referred to our hospital for an abnormal shadow of chest X-ray in the upper right lung field. Chest CT showed 3.5 cm of tumor located at the apex of right lobe with invasion of the chest wall. The tumor was diagnosed as squamous cell carcinoma using CT guided needle biopsy(superior sulcus tumor, clinical T3N0M0, StageⅡB). The neoadjuvant therapy, 4 courses of chemotherapy(CBDCA plus PTX)and concurrent radiotherapy(45 Gy/25 Fr)was performed. Chest CT revealed that tumor size was decreased to 2.3 cm in a diameter, and therapeutic effect was decided as partial response(34%). Upper right lobectomy combined with the chest wall(1th to 3th ribs)and mediastinal lymph node dissection were performed. The pathological specimens showed no residual cancer cells(Ef3, pathological complete response[pCR]). She discharged without complications at 10 days after surgery. It is important to collect cases which obtained pCR for development of more effective preoperative therapy.
要旨
症例は73歳,女性。近医での胸部単純X線にて右上肺野に胸部異常陰影を指摘され,当院へ紹介された。胸部CTで右肺尖部に胸壁浸潤を伴う長径3.5 cmの腫瘍を認め,CTガイド下生検で扁平上皮癌と診断された。肺尖部胸壁浸潤癌,cT3N0M0,cStageⅡBの診断で,術前放射線化学療法(CBDCA+PTX療法を4コース,放射線治療45 Gy/25 Fr)を同時併用で施行した。効果判定の胸部CTでは腫瘍は長径2.3 cmと縮小を認め,部分奏効(縮小率34%)と判定した。右肺上葉切除,胸壁(第1～3肋骨)合併切除,縦隔リンパ節郭清を施行した。病理組織学的検査ではviableな腫瘍細胞は認められず(Ef3),病理学的完全奏効(pCR)であった。術後10日,合併症なく退院した。本症例のように術前治療にてpCRを得た症例を集積し,より有効な術前治療開発の必要があると考えられた。
目次
Summary
The current case was 73-year-old woman. She was referred to our hospital for an abnormal shadow of chest X-ray in the upper right lung field. Chest CT showed 3.5 cm of tumor located at the apex of right lobe with invasion of the chest wall. The tumor was diagnosed as squamous cell carcinoma using CT guided needle biopsy(superior sulcus tumor, clinical T3N0M0, StageⅡB). The neoadjuvant therapy, 4 courses of chemotherapy(CBDCA plus PTX)and concurrent radiotherapy(45 Gy/25 Fr)was performed. Chest CT revealed that tumor size was decreased to 2.3 cm in a diameter, and therapeutic effect was decided as partial response(34%). Upper right lobectomy combined with the chest wall(1th to 3th ribs)and mediastinal lymph node dissection were performed. The pathological specimens showed no residual cancer cells(Ef3, pathological complete response[pCR]). She discharged without complications at 10 days after surgery. It is important to collect cases which obtained pCR for development of more effective preoperative therapy.
要旨
症例は73歳,女性。近医での胸部単純X線にて右上肺野に胸部異常陰影を指摘され,当院へ紹介された。胸部CTで右肺尖部に胸壁浸潤を伴う長径3.5 cmの腫瘍を認め,CTガイド下生検で扁平上皮癌と診断された。肺尖部胸壁浸潤癌,cT3N0M0,cStageⅡBの診断で,術前放射線化学療法(CBDCA+PTX療法を4コース,放射線治療45 Gy/25 Fr)を同時併用で施行した。効果判定の胸部CTでは腫瘍は長径2.3 cmと縮小を認め,部分奏効(縮小率34%)と判定した。右肺上葉切除,胸壁(第1～3肋骨)合併切除,縦隔リンパ節郭清を施行した。病理組織学的検査ではviableな腫瘍細胞は認められず(Ef3),病理学的完全奏効(pCR)であった。術後10日,合併症なく退院した。本症例のように術前治療にてpCRを得た症例を集積し,より有効な術前治療開発の必要があると考えられた。