内容紹介
Summary
We report the case of a 68-year-old male with EGJ cancer, who was treated with palliative radiotherapy for persistent bleeding, and for whom, pCR was ultimately obtained by chemotherapy. Chemotherapy was planned to treat the EGJ cancer with intramural metastasis of the esophagus, but anemia due to persistent bleeding from the tumor was noted. Even with frequent blood transfusions, the anemia was difficult to control. Palliative radiotherapy was performed at 30 Gy/10 Fr for hemostasis, followed by chemotherapy. After approximately 9 months of chemotherapy, reduction of the primary tumor, a metastatic lymph node, and disappearance of the intramural metastasis of the esophagus were noted, and conversion surgery was performed. In the final histopathological examination, pCR was obtained. Radiotherapy for persistent bleeding from advanced gastric cancer is a minimally invasive treatment, and therefore could be an effective treatment to enable chemotherapy without any loss of compliance.
要旨
今回われわれは,食道胃接合部癌の持続性出血に対して止血目的に放射線治療を行い,その後化学療法でpCRが得られた症例を経験した。症例は68歳,男性。食道壁内転移を伴う食道胃接合部癌に対して化学療法を予定していたが,腫瘍からの持続性出血による貧血を認めていた。頻回の輸血を行うも出血コントロールが困難であった。止血目的に放射線治療30Gy/10 Frの照射を行い,その後化学療法を開始した。約9か月の化学療法により壁内転移の消失,原発巣,転移リンパ節の縮小を認めconversion surgeryを行った。最終病理組織学的検査では腫瘍は消失しており,pCRの診断であった。出血性進行胃癌に対する放射線治療は低侵襲に止血を得られることができ,コンプライアンスの低下なく化学療法を可能とする有効な治療法となり得ると考えられた。
目次
We report the case of a 68-year-old male with EGJ cancer, who was treated with palliative radiotherapy for persistent bleeding, and for whom, pCR was ultimately obtained by chemotherapy. Chemotherapy was planned to treat the EGJ cancer with intramural metastasis of the esophagus, but anemia due to persistent bleeding from the tumor was noted. Even with frequent blood transfusions, the anemia was difficult to control. Palliative radiotherapy was performed at 30 Gy/10 Fr for hemostasis, followed by chemotherapy. After approximately 9 months of chemotherapy, reduction of the primary tumor, a metastatic lymph node, and disappearance of the intramural metastasis of the esophagus were noted, and conversion surgery was performed. In the final histopathological examination, pCR was obtained. Radiotherapy for persistent bleeding from advanced gastric cancer is a minimally invasive treatment, and therefore could be an effective treatment to enable chemotherapy without any loss of compliance.
要旨
今回われわれは,食道胃接合部癌の持続性出血に対して止血目的に放射線治療を行い,その後化学療法でpCRが得られた症例を経験した。症例は68歳,男性。食道壁内転移を伴う食道胃接合部癌に対して化学療法を予定していたが,腫瘍からの持続性出血による貧血を認めていた。頻回の輸血を行うも出血コントロールが困難であった。止血目的に放射線治療30Gy/10 Frの照射を行い,その後化学療法を開始した。約9か月の化学療法により壁内転移の消失,原発巣,転移リンパ節の縮小を認めconversion surgeryを行った。最終病理組織学的検査では腫瘍は消失しており,pCRの診断であった。出血性進行胃癌に対する放射線治療は低侵襲に止血を得られることができ,コンプライアンスの低下なく化学療法を可能とする有効な治療法となり得ると考えられた。