内容紹介
Summary
A 50s man was diagnosed with esophagogastric junction cancer. Simultaneously, PET-CT demonstrated mediastinal lymph node metastases. Two months later, 4 courses of systemic chemotherapy(SOX)were provided as preoperative therapy. However, the outcome was PD; therefore, radical gastrectomy could not be performed. Two more months later, esophageal dysphagia developed. Mediastinal lymph nodes that compressed the esophagus and the primary lesion of the cardia were considered to be the causes of dysphagia, and transcatheter arterial chemoembolization targeting those 2 lesions was performed. Cisplatin 20 mg, docetaxel 20 mg, and 5-FU 250 mg were the drugs administered. These drugs were injected from the right bronchial artery, left gastric artery, and left phrenic artery, followed by mild embolization with HepaSphereTM. The mediastinal lymph nodes shrunk significantly, and dysphagia improved with 2 sessions. The primary lesion was found to have reduced in size with 6 sessions. Currently, no regrowth of the mediastinal lymph nodes has been observed 16 months(9sessions)after the first session, and control of the primary lesion has been obtained.
要旨
症例は50歳台,男性。食道胃接合部癌および縦隔リンパ節転移と診断された。SOX療法4コースが施行されたが,PDにて根治手術不能となった。2か月後に食道通過障害が発症した。食道を圧排する縦隔リンパ節と噴門部原発巣が通過障害の原因とされ,動注塞栓術が選択された。薬剤はシスプラチン20 mg,ドセタキセル20 mg,5-FU 250 mgを用いて,右気管支動脈,左胃動脈,左下横隔動脈から注入し,ヘパスフィア™を用いて塞栓術を行った。2回の治療で縦隔リンパ節は著明に縮小し,通過障害は改善し,6回の治療で原発巣の縮小を認めた。現在,初回治療から16か月(9回の治療)が経過し,縦隔リンパ節の再増大は認めず,原発巣の制御も得られている。
目次
A 50s man was diagnosed with esophagogastric junction cancer. Simultaneously, PET-CT demonstrated mediastinal lymph node metastases. Two months later, 4 courses of systemic chemotherapy(SOX)were provided as preoperative therapy. However, the outcome was PD; therefore, radical gastrectomy could not be performed. Two more months later, esophageal dysphagia developed. Mediastinal lymph nodes that compressed the esophagus and the primary lesion of the cardia were considered to be the causes of dysphagia, and transcatheter arterial chemoembolization targeting those 2 lesions was performed. Cisplatin 20 mg, docetaxel 20 mg, and 5-FU 250 mg were the drugs administered. These drugs were injected from the right bronchial artery, left gastric artery, and left phrenic artery, followed by mild embolization with HepaSphereTM. The mediastinal lymph nodes shrunk significantly, and dysphagia improved with 2 sessions. The primary lesion was found to have reduced in size with 6 sessions. Currently, no regrowth of the mediastinal lymph nodes has been observed 16 months(9sessions)after the first session, and control of the primary lesion has been obtained.
要旨
症例は50歳台,男性。食道胃接合部癌および縦隔リンパ節転移と診断された。SOX療法4コースが施行されたが,PDにて根治手術不能となった。2か月後に食道通過障害が発症した。食道を圧排する縦隔リンパ節と噴門部原発巣が通過障害の原因とされ,動注塞栓術が選択された。薬剤はシスプラチン20 mg,ドセタキセル20 mg,5-FU 250 mgを用いて,右気管支動脈,左胃動脈,左下横隔動脈から注入し,ヘパスフィア™を用いて塞栓術を行った。2回の治療で縦隔リンパ節は著明に縮小し,通過障害は改善し,6回の治療で原発巣の縮小を認めた。現在,初回治療から16か月(9回の治療)が経過し,縦隔リンパ節の再増大は認めず,原発巣の制御も得られている。