内容紹介
Summary
Docetaxel, cisplatin, and 5-FU(DCF)chemotherapy for esophageal cancer has been reported to be highly effective, but often causes serious adverse events, including severe bone marrow suppression. We report the successful treatment of a 67-year-old man with highly advanced esophageal cancer with invasion of the left bronchus and broad lymph node metastases. He received induction chemotherapy with DCF therapy, and prophylactic administration of pegfilgrastim. He safely completed 5 courses of DCF therapy without serious adverse events, such as neutropenia and febrile neutropenia. The size of the primary tumor and lymph node metastases remarkably reduced after the third course of DCF. He underwent thoracoscopic esophagectomy with three-field lymph node dissection and reconstruction with a gastric tube. The pathological findings of the resected specimen showed no viable malignant cells in the primary lesion and the pathological effect after chemotherapy was judged as Grade 3. Viable cancer cells still remained in 10 lymph nodes in the dissected field. DCF therapy with prophylactic administration of pegfilgrastim may be an effective and safe treatment for advanced esophageal cancer.
要旨
症例は67歳,男性。食事のつかえ感を主訴に近医を受診し,cT4b(左気管支),cN4(101R,102L,104L,106recR,108,109R,7,8a,8p,14A,16b1),cM0,cStage Ⅳaの高度進行食道癌と診断され当科紹介となった。導入化学療法として,ペグフィルグラスチム併用docetaxel, cisplatin, 5-FU(DCF)療法を5コース施行した。治療期間中に減量や中止を要する有害事象は出現しなかった。3コース目以降に原発巣とリンパ節転移に著明な縮小を認め,胸腔鏡下食道切除再建術を施行した。切除標本の病理診断は,原発巣に腫瘍細胞を認めず,組織学的判定はGrade 3であったが,10個の郭清リンパ節にviable cellの遺残を認めた。今回,ペグフィルグラスチムを併用することで安全にDCF療法を継続でき,conversion resectionを行い得た高度進行食道癌の1例を経験したので報告する。
目次
Docetaxel, cisplatin, and 5-FU(DCF)chemotherapy for esophageal cancer has been reported to be highly effective, but often causes serious adverse events, including severe bone marrow suppression. We report the successful treatment of a 67-year-old man with highly advanced esophageal cancer with invasion of the left bronchus and broad lymph node metastases. He received induction chemotherapy with DCF therapy, and prophylactic administration of pegfilgrastim. He safely completed 5 courses of DCF therapy without serious adverse events, such as neutropenia and febrile neutropenia. The size of the primary tumor and lymph node metastases remarkably reduced after the third course of DCF. He underwent thoracoscopic esophagectomy with three-field lymph node dissection and reconstruction with a gastric tube. The pathological findings of the resected specimen showed no viable malignant cells in the primary lesion and the pathological effect after chemotherapy was judged as Grade 3. Viable cancer cells still remained in 10 lymph nodes in the dissected field. DCF therapy with prophylactic administration of pegfilgrastim may be an effective and safe treatment for advanced esophageal cancer.
要旨
症例は67歳,男性。食事のつかえ感を主訴に近医を受診し,cT4b(左気管支),cN4(101R,102L,104L,106recR,108,109R,7,8a,8p,14A,16b1),cM0,cStage Ⅳaの高度進行食道癌と診断され当科紹介となった。導入化学療法として,ペグフィルグラスチム併用docetaxel, cisplatin, 5-FU(DCF)療法を5コース施行した。治療期間中に減量や中止を要する有害事象は出現しなかった。3コース目以降に原発巣とリンパ節転移に著明な縮小を認め,胸腔鏡下食道切除再建術を施行した。切除標本の病理診断は,原発巣に腫瘍細胞を認めず,組織学的判定はGrade 3であったが,10個の郭清リンパ節にviable cellの遺残を認めた。今回,ペグフィルグラスチムを併用することで安全にDCF療法を継続でき,conversion resectionを行い得た高度進行食道癌の1例を経験したので報告する。