内容紹介
Summary
A 65-year-old woman underwent mastectomy and dissection of a level Ⅰ axillary lymph node in January 2002 for left breast cancer. The diagnosis was T1N0M0 scirrhous carcinoma that was estrogen receptor-positive, progesterone receptor-positive, and human epidermal growth factor receptor 2-negative. After 3 years 10 months, during which the patient underwent adjuvant therapy with oral aromatase inhibitors, she developed bilateral multiple lung metastases. These were treated with the anticancer agents anthracycline and taxane. Progressive disease(more and larger lung metastases)was diagnosed in April 2013, and bevacizumab plus paclitaxel combination therapy was started. After completion of 4 courses, a lung abscess appeared, which was conjectured to represent rapid tumor necrosis that had become infected. As several tumors remained solid even after the lung abscess improved, the patient received 18 courses of eribulin monotherapy. Computed tomography in April 2016 revealed only patches of linear or cord-like scarring in both lungs, with no metastatic or recurrent foci. In this case, a patient with recurrent breast cancer responded to the sequential administration of bevacizumab plus paclitaxel combination therapy followed by eribulin monotherapy.
要旨
症例は65歳,女性。左乳癌に対し2002年1月Bt+Ax(Ⅰ)を施行した。硬癌,T1N0M0,ER・PR陽性,HER2陰性であり,術後補助療法としてアロマターゼ阻害剤を内服中の3年10か月目に両側多発肺転移が出現した。化学療法を行う方針とし,アンスラサイクリン系からタキサン系抗癌剤を順次使用,肺転移巣の増加増大(PD)となった2013年4月よりbevacizumab+paclitaxel併用療法を開始した。4コース終了した時点で肺膿瘍が併発,急激な腫瘍壊死に感染が被って生じたと推測された。肺膿瘍が改善した後もいくつかの腫瘍は充実性のまま残存していたため,さらにeribulin単剤療法を18コース行った。2016年4月のCT検査では両肺に線状～索状の瘢痕が散在するのみで,転移再発巣を認めなかった。bevacizumab+paclitaxel併用療法からeribulin単剤療法の逐次投与が奏効した再発乳癌の1例を経験した。
目次
A 65-year-old woman underwent mastectomy and dissection of a level Ⅰ axillary lymph node in January 2002 for left breast cancer. The diagnosis was T1N0M0 scirrhous carcinoma that was estrogen receptor-positive, progesterone receptor-positive, and human epidermal growth factor receptor 2-negative. After 3 years 10 months, during which the patient underwent adjuvant therapy with oral aromatase inhibitors, she developed bilateral multiple lung metastases. These were treated with the anticancer agents anthracycline and taxane. Progressive disease(more and larger lung metastases)was diagnosed in April 2013, and bevacizumab plus paclitaxel combination therapy was started. After completion of 4 courses, a lung abscess appeared, which was conjectured to represent rapid tumor necrosis that had become infected. As several tumors remained solid even after the lung abscess improved, the patient received 18 courses of eribulin monotherapy. Computed tomography in April 2016 revealed only patches of linear or cord-like scarring in both lungs, with no metastatic or recurrent foci. In this case, a patient with recurrent breast cancer responded to the sequential administration of bevacizumab plus paclitaxel combination therapy followed by eribulin monotherapy.
要旨
症例は65歳,女性。左乳癌に対し2002年1月Bt+Ax(Ⅰ)を施行した。硬癌,T1N0M0,ER・PR陽性,HER2陰性であり,術後補助療法としてアロマターゼ阻害剤を内服中の3年10か月目に両側多発肺転移が出現した。化学療法を行う方針とし,アンスラサイクリン系からタキサン系抗癌剤を順次使用,肺転移巣の増加増大(PD)となった2013年4月よりbevacizumab+paclitaxel併用療法を開始した。4コース終了した時点で肺膿瘍が併発,急激な腫瘍壊死に感染が被って生じたと推測された。肺膿瘍が改善した後もいくつかの腫瘍は充実性のまま残存していたため,さらにeribulin単剤療法を18コース行った。2016年4月のCT検査では両肺に線状～索状の瘢痕が散在するのみで,転移再発巣を認めなかった。bevacizumab+paclitaxel併用療法からeribulin単剤療法の逐次投与が奏効した再発乳癌の1例を経験した。