内容紹介
Summary
A 79-year-old woman had recurrence in the mediastinal lymph node 6 months after curative resection of advanced esophageal cancer(pStage Ⅲ). After radiation therapy and 12 courses of chemotherapy with docetaxel, new recurrent tumors progressed in the mediastinum and apical region of the left lung, and her performance status(PS)deteriorated to grade 3. Alternate-day, low-dose S-1 chemotherapy was started at a dose of 60 mg/day. Tumors decreased in size within 6 months, and her PS improved from grade 3 to 0. She had been treated for 33 months without severe adverse events until disease progression. So far, we have experienced in clinical practices that the alternate-day S-1 administration was tolerable for patients who were unfit for the standard daily administration. Alternate-day, low-dose S-1 administration may be a sustainable and effective option in S-1 chemotherapy in patients with recurrent esophageal cancer with impaired PS.
要旨
症例は79歳,女性。食道癌,cStage Ⅲに対して術前化学療法,鏡視下手術を施行した。術後6か月目で単発の縦隔リンパ節再発を認め,放射線治療後にdocetaxel単剤療法を開始した。12コースまで継続したが縦隔および肺尖部に新規再発病変が出現,病勢進行によりperformance status(PS)3となった。S-1低用量隔日投与を開始したところ,6か月後には腫瘍縮小を認め栄養状態とともにPS 0へと著明に改善し,2年9か月の長期にわたり目立った副作用なく治療を継続し得た。食道癌に対する標準治療では有効とされる薬剤に限りがある上,全身状態が低下した高齢患者には適用が困難な場合もある。全身状態不良の進行再発食道癌の後方ラインにおいて,S-1低用量隔日投与は抗腫瘍効果を担保しつつ忍容性・継続性を兼ね備えた有望な選択肢となる可能性がある。
目次
A 79-year-old woman had recurrence in the mediastinal lymph node 6 months after curative resection of advanced esophageal cancer(pStage Ⅲ). After radiation therapy and 12 courses of chemotherapy with docetaxel, new recurrent tumors progressed in the mediastinum and apical region of the left lung, and her performance status(PS)deteriorated to grade 3. Alternate-day, low-dose S-1 chemotherapy was started at a dose of 60 mg/day. Tumors decreased in size within 6 months, and her PS improved from grade 3 to 0. She had been treated for 33 months without severe adverse events until disease progression. So far, we have experienced in clinical practices that the alternate-day S-1 administration was tolerable for patients who were unfit for the standard daily administration. Alternate-day, low-dose S-1 administration may be a sustainable and effective option in S-1 chemotherapy in patients with recurrent esophageal cancer with impaired PS.
要旨
症例は79歳,女性。食道癌,cStage Ⅲに対して術前化学療法,鏡視下手術を施行した。術後6か月目で単発の縦隔リンパ節再発を認め,放射線治療後にdocetaxel単剤療法を開始した。12コースまで継続したが縦隔および肺尖部に新規再発病変が出現,病勢進行によりperformance status(PS)3となった。S-1低用量隔日投与を開始したところ,6か月後には腫瘍縮小を認め栄養状態とともにPS 0へと著明に改善し,2年9か月の長期にわたり目立った副作用なく治療を継続し得た。食道癌に対する標準治療では有効とされる薬剤に限りがある上,全身状態が低下した高齢患者には適用が困難な場合もある。全身状態不良の進行再発食道癌の後方ラインにおいて,S-1低用量隔日投与は抗腫瘍効果を担保しつつ忍容性・継続性を兼ね備えた有望な選択肢となる可能性がある。