内容紹介
Summary
We report three cases of advanced lung cancer with poor PS treated with molecular-targeted drugs and consider the role of cancer chemotherapy to improve quality of life(QOL). Case 1: A 67-year-old woman(PS 3)with multiple liver, bone, and lymph node metastases from lung cancer received gefitinib and radiation therapy for bone metastasis. Abdominal CT then showed shrinkage of the liver metastasis, and daily life activities became possible after 2 months. Case 2: A 76-year-old woman with SVC syndrome from Stage ⅢA of lung cancer received gefitinib and radiation therapy. After that, edema and cough disappeared, and the PS improved from 3 to 0. Case 3: A 41-year-old woman with pleural dissemination from Stage Ⅳ lung cancer received ALK inhibitors and anticancer drug therapy for 5 years. Subsequently, a decrease in QOL was noted due to symptoms such as bloody sputum and persistence of cough. ALK inhibitors were administered as a re-challenge. A dramatic improvement in symptoms was observed in a few days. Even if the general condition is poor, PS can be improved by administering drugs such as molecular-targeted drugs.
要旨
全身状態不良やperformance status(PS)低下例において,積極的に治療を検討する価値のある患者像の指標となる症例を経験したので,PSの改善を期待したがん化学療法の役割について文献的考察を加えて報告する。症例1: 67歳,女性。肺腺癌の膵,多発肝転移,骨,リンパ節転移,癌性胸膜炎,PS 3。gefitinibと骨転移に対する放射線治療により,2か月後には日常生活が可能となった。症例2: 76歳,女性。肺腺癌のⅢA期,SVC症候群,PS 3。放射線治療,gefitinibを開始後,浮腫は改善,咳嗽は消失し,PS 0となった。症例3: 41歳,女性。肺腺癌,胸膜播種,Ⅳ期。ALK阻害剤,殺細胞性抗がん剤単剤などで加療継続,開始から5年で血痰,咳の持続などQOLの低下があり,ALK阻害剤再投与。数日で症状の劇的な改善がみられた。緩和ケアの現場においては,状況によっては治療ができないかという視点で患者に対応する必要がある。
目次
We report three cases of advanced lung cancer with poor PS treated with molecular-targeted drugs and consider the role of cancer chemotherapy to improve quality of life(QOL). Case 1: A 67-year-old woman(PS 3)with multiple liver, bone, and lymph node metastases from lung cancer received gefitinib and radiation therapy for bone metastasis. Abdominal CT then showed shrinkage of the liver metastasis, and daily life activities became possible after 2 months. Case 2: A 76-year-old woman with SVC syndrome from Stage ⅢA of lung cancer received gefitinib and radiation therapy. After that, edema and cough disappeared, and the PS improved from 3 to 0. Case 3: A 41-year-old woman with pleural dissemination from Stage Ⅳ lung cancer received ALK inhibitors and anticancer drug therapy for 5 years. Subsequently, a decrease in QOL was noted due to symptoms such as bloody sputum and persistence of cough. ALK inhibitors were administered as a re-challenge. A dramatic improvement in symptoms was observed in a few days. Even if the general condition is poor, PS can be improved by administering drugs such as molecular-targeted drugs.
要旨
全身状態不良やperformance status(PS)低下例において,積極的に治療を検討する価値のある患者像の指標となる症例を経験したので,PSの改善を期待したがん化学療法の役割について文献的考察を加えて報告する。症例1: 67歳,女性。肺腺癌の膵,多発肝転移,骨,リンパ節転移,癌性胸膜炎,PS 3。gefitinibと骨転移に対する放射線治療により,2か月後には日常生活が可能となった。症例2: 76歳,女性。肺腺癌のⅢA期,SVC症候群,PS 3。放射線治療,gefitinibを開始後,浮腫は改善,咳嗽は消失し,PS 0となった。症例3: 41歳,女性。肺腺癌,胸膜播種,Ⅳ期。ALK阻害剤,殺細胞性抗がん剤単剤などで加療継続,開始から5年で血痰,咳の持続などQOLの低下があり,ALK阻害剤再投与。数日で症状の劇的な改善がみられた。緩和ケアの現場においては,状況によっては治療ができないかという視点で患者に対応する必要がある。