内容紹介
Summary
The patient was a 69-year-old woman. Upper gastrointestinal endoscopy showed a protruding tumor in the mid-thoracic esophagus, and biopsy revealed small cell carcinoma in November 2012. Four courses of neoadjuvant chemotherapy comprising CDDP and CPT-11 were administered, and radical resection was performed in March 2013. In March 2014, chest computed tomography revealed the recurrence of mediastinal lymph nodes; thus, we administered chemoradiotherapy comprising 5-FU and CDDP, and the size of the recurrent tumors decreased. However, in February 2015, positron emission tomography-computed tomography revealed liver metastases. Therefore, we switched to a new chemotherapy regimen containing CDDP and VP-16. Although the treatment was very effective and the liver metastases significantly decreased in size, it was discontinued after 9 courses owing to neurotoxicity. Next, 7 courses of chemotherapy comprising amrubicin, which is administered for treating small cell lung carcinoma, were administered, which suppressed tumor growth for approximately 8 months. However, the tumor then re-grew. Chemotherapy comprising S-1 was administered; however, the tumor gradually progressed. The patient died 51 months after the initial treatment.
要旨
症例は69歳,女性。胸部中部食道に腫瘤性病変を認め,生検にて小細胞癌と診断された。転移のない限局症例であり,IP療法後に食道亜全摘術を施行した。術後12か月後に縦隔リンパ節再発を認め,化学放射線療法を施行し同病変は制御できたが,その後に肝転移が出現した。EP療法にて縮小し,その後アムルビシン,S-1と化学療法を続けたが肝転移巣が再増大し,診断51か月後に死亡した。食道小細胞癌の集学的治療の意義を考える上で示唆に富む症例であり報告する。
目次
The patient was a 69-year-old woman. Upper gastrointestinal endoscopy showed a protruding tumor in the mid-thoracic esophagus, and biopsy revealed small cell carcinoma in November 2012. Four courses of neoadjuvant chemotherapy comprising CDDP and CPT-11 were administered, and radical resection was performed in March 2013. In March 2014, chest computed tomography revealed the recurrence of mediastinal lymph nodes; thus, we administered chemoradiotherapy comprising 5-FU and CDDP, and the size of the recurrent tumors decreased. However, in February 2015, positron emission tomography-computed tomography revealed liver metastases. Therefore, we switched to a new chemotherapy regimen containing CDDP and VP-16. Although the treatment was very effective and the liver metastases significantly decreased in size, it was discontinued after 9 courses owing to neurotoxicity. Next, 7 courses of chemotherapy comprising amrubicin, which is administered for treating small cell lung carcinoma, were administered, which suppressed tumor growth for approximately 8 months. However, the tumor then re-grew. Chemotherapy comprising S-1 was administered; however, the tumor gradually progressed. The patient died 51 months after the initial treatment.
要旨
症例は69歳,女性。胸部中部食道に腫瘤性病変を認め,生検にて小細胞癌と診断された。転移のない限局症例であり,IP療法後に食道亜全摘術を施行した。術後12か月後に縦隔リンパ節再発を認め,化学放射線療法を施行し同病変は制御できたが,その後に肝転移が出現した。EP療法にて縮小し,その後アムルビシン,S-1と化学療法を続けたが肝転移巣が再増大し,診断51か月後に死亡した。食道小細胞癌の集学的治療の意義を考える上で示唆に富む症例であり報告する。