内容紹介
Complete Response of Locally Recurrent Anorectal Cancer to Proton Beam Therapy Alone―A Case Report
Summary
We report a case of locally recurrent anorectal cancer treated with proton beam therapy(PBT)alone that led to a clinically complete response. A 70-year-old woman with paraparesis due to infantile paralysis underwent abdominoperineal resection(APR)and D3 lymphadenectomy for anorectal cancer(PERb, type 2, 50×40 mm, muc-tub1, M1a[lung], StageⅣa]. Three months after APR, right middle and right lower lobectomies were performed for synchronous lung metastases. Adjuvant chemotherapy was not administered. One year and 8 months after APR, computed tomography(CT)showed local recurrence of the tumor(29×28 mm), which contacted the right ischial spine. Pelvic exenteration combined with sacral resection was not performed because of the patient's poor performance status. PBT(70 Gy[RBE]/25 F/5 week)was administered for treatment of the recurred tumor. CT revealed that the tumor disappeared 1 year after PBT, which was defined as complete response. The patient is alive and has not experienced recurrence for 7 years.
要旨
肛門管癌術後局所再発に対して,陽子線治療単独でcomplete response(CR)となり長期生存を得た症例を経験したので報告する。症例は77歳,女性。70歳時に肛門管癌に対して腹会陰式直腸切断術施行し,3か月後に同時性肺転移に対して右肺中葉,右下葉部分切除術施行した。原発切除後1年8か月のCTで内腸骨末梢リンパ節領域に坐骨棘に接する腫瘍を認め,局所再発と診断。小児麻痺の既往(PS 2)があり,過大侵襲を伴う手術は適応外と判断した。そこで,本人希望により陽子線治療[70 Gy(RBE)/25回/5週]を施行。照射終了後1年のCTで腫瘤陰影の消失を認め,CRと判定。陽子線治療後7年が経過し,無再発生存中である。
目次
Summary
We report a case of locally recurrent anorectal cancer treated with proton beam therapy(PBT)alone that led to a clinically complete response. A 70-year-old woman with paraparesis due to infantile paralysis underwent abdominoperineal resection(APR)and D3 lymphadenectomy for anorectal cancer(PERb, type 2, 50×40 mm, muc-tub1, M1a[lung], StageⅣa]. Three months after APR, right middle and right lower lobectomies were performed for synchronous lung metastases. Adjuvant chemotherapy was not administered. One year and 8 months after APR, computed tomography(CT)showed local recurrence of the tumor(29×28 mm), which contacted the right ischial spine. Pelvic exenteration combined with sacral resection was not performed because of the patient's poor performance status. PBT(70 Gy[RBE]/25 F/5 week)was administered for treatment of the recurred tumor. CT revealed that the tumor disappeared 1 year after PBT, which was defined as complete response. The patient is alive and has not experienced recurrence for 7 years.
要旨
肛門管癌術後局所再発に対して,陽子線治療単独でcomplete response(CR)となり長期生存を得た症例を経験したので報告する。症例は77歳,女性。70歳時に肛門管癌に対して腹会陰式直腸切断術施行し,3か月後に同時性肺転移に対して右肺中葉,右下葉部分切除術施行した。原発切除後1年8か月のCTで内腸骨末梢リンパ節領域に坐骨棘に接する腫瘍を認め,局所再発と診断。小児麻痺の既往(PS 2)があり,過大侵襲を伴う手術は適応外と判断した。そこで,本人希望により陽子線治療[70 Gy(RBE)/25回/5週]を施行。照射終了後1年のCTで腫瘤陰影の消失を認め,CRと判定。陽子線治療後7年が経過し,無再発生存中である。