内容紹介
A Case of Recurrent Endometrial Carcinoma with Pleural Effusion Maintained Long SD by Pegylated Liposomal Doxorubicin(PLD)Chemotherapy
Summary
We experienced a case of long SD through the use of pegylated liposomal doxorubicin(PLD)chemotherapy for recurrent endometrial carcinoma with pleural effusion. The patient was an 82-year-old woman with recurrent endometrial carcinoma. At 76 years of age, she underwent extended abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic・paraaortic lymphadenectomy for the diagnosis of endometrial carcinoma(serous adenocarcinoma)StageⅢc. She also received adjuvant chemotherapy with paclitaxel(175 mg/m2)and carboplatin(AUC 6), and radiotherapy. Forty-six months after the first treatment, the tumor marker CA125 level was elevated, and recurrent tumors at the vaginal stump and peritoneal dissemination were recognized. Then, second-line chemotherapy with docetaxel(70 mg/m2)and carboplatin(AUC5)were administered, and CR was achieved. After 6 months, a second relapse occurred. She felt severe dyspnea from the massive pleural effusion, and underwent PLD(40 mg/m2)monotherapy to control the disease progress and to maintain her quality of life. After 5 courses of PLD treatment, the pleural effusion clearly diminished, and the CA125 level decreased. The toxicity was generally mild. This case suggests that PLD may be one of the promising drugs for recurrent endometrial carcinoma.
要旨
既治療歴のある再発子宮体癌に対しpegylated liposomal doxorubicin,ドキシル注(PLD)を投与し,長期のdisease controlが可能であった症例を報告する。症例は82歳,女性。76歳時に子宮体癌(漿液性腺癌)StageⅢcに対し,準広汎子宮全摘術+両側付属器切除術+骨盤・傍大動脈リンパ節郭清術を施行し,術後TC(paclitaxel/carboplatin)療法6コースと,全骨盤照射(50.4 Gy)を行った。初回治療より46か月後,腫瘍マーカーCA125の上昇と腟断端再発・腹膜播種を認め,DC(docetaxel/carboplatin)療法6コース施行した。病巣はいったん消失したが,6か月後に再びCA125上昇,腹膜播種と胸水貯留を認め,子宮体癌再々発の診断となった。呼吸苦が強く,performance status(PS)も不良であることからPLD単剤療法を行った。投与5コース目まで胸水減少とCA125低下を認め,6か月間stable disease(SD)を維持することができ,副作用も軽微であった。PLD療法は,既治療子宮体癌再発に対して有望な化学療法であると考えられた。
目次
Summary
We experienced a case of long SD through the use of pegylated liposomal doxorubicin(PLD)chemotherapy for recurrent endometrial carcinoma with pleural effusion. The patient was an 82-year-old woman with recurrent endometrial carcinoma. At 76 years of age, she underwent extended abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic・paraaortic lymphadenectomy for the diagnosis of endometrial carcinoma(serous adenocarcinoma)StageⅢc. She also received adjuvant chemotherapy with paclitaxel(175 mg/m2)and carboplatin(AUC 6), and radiotherapy. Forty-six months after the first treatment, the tumor marker CA125 level was elevated, and recurrent tumors at the vaginal stump and peritoneal dissemination were recognized. Then, second-line chemotherapy with docetaxel(70 mg/m2)and carboplatin(AUC5)were administered, and CR was achieved. After 6 months, a second relapse occurred. She felt severe dyspnea from the massive pleural effusion, and underwent PLD(40 mg/m2)monotherapy to control the disease progress and to maintain her quality of life. After 5 courses of PLD treatment, the pleural effusion clearly diminished, and the CA125 level decreased. The toxicity was generally mild. This case suggests that PLD may be one of the promising drugs for recurrent endometrial carcinoma.
要旨
既治療歴のある再発子宮体癌に対しpegylated liposomal doxorubicin,ドキシル注(PLD)を投与し,長期のdisease controlが可能であった症例を報告する。症例は82歳,女性。76歳時に子宮体癌(漿液性腺癌)StageⅢcに対し,準広汎子宮全摘術+両側付属器切除術+骨盤・傍大動脈リンパ節郭清術を施行し,術後TC(paclitaxel/carboplatin)療法6コースと,全骨盤照射(50.4 Gy)を行った。初回治療より46か月後,腫瘍マーカーCA125の上昇と腟断端再発・腹膜播種を認め,DC(docetaxel/carboplatin)療法6コース施行した。病巣はいったん消失したが,6か月後に再びCA125上昇,腹膜播種と胸水貯留を認め,子宮体癌再々発の診断となった。呼吸苦が強く,performance status(PS)も不良であることからPLD単剤療法を行った。投与5コース目まで胸水減少とCA125低下を認め,6か月間stable disease(SD)を維持することができ,副作用も軽微であった。PLD療法は,既治療子宮体癌再発に対して有望な化学療法であると考えられた。