内容紹介
A Case of Advanced Esophageal Cancer Revealed a Pathological Complete Response and Survived More than 8 Years, Treated by Radiation Therapy Combined with Nedaplatin and 5-FU Chemotherapy
Summary
We report here the long-term survival case of advanced esophageal cancer treated with definitive chemoradiotherapy(CRT). A 61-year-old woman visited our hospital because of a disturbance in her swallowing in September, 2003. She was diagnosed with a middle esophageal type 3 tumor, which was 9 cm in length by endoscopy. Squamous cell carcinoma was diagnosed by pre-operative endoscopic biopsy. CT revealed the tumor with direct invasion to the aorta, and multiple metastases of the lymph nodes(T4, N1, M0: Stage Ⅳa). CRT(combination of 5-FU and nedaplatin with 40 Gy of radiation)was administered. After the completion of CRT, the tumor size was remarkably reduced, but stenosis of the lumen of the esophagus remained partially. Therefore, we performed sub-total esophagectomy in February, 2004. A pathological complete response was diagnosed with no carcinoma cells evident in the resected specimen. Pathological therapeutic evaluation of the esophageal cancer was grade 3. The patient had received no adjuvant chemotherapy, but she is alive and healthy now with no relapse of carcinoma for more than 8 years after operation.
要旨
今回われわれは,進行食道癌に対してcis-diammineglycolatoplatinum(CDGP): Nedaplatin®(CDGP)を使用した化学放射線療法を行った後に手術を施行し,8年以上無再発の症例を経験したので報告する。症例は61歳,女性。嚥下困難で2003年11月当院を受診した。上部消化管内視鏡検査で食道入口部より25 cmのMtに9 cm長の3型腫瘤を指摘され,生検で扁平上皮癌と確定した。CTで腫瘤の大動脈および左房への浸潤が疑われた。原発巣と一塊となったリンパ節も認め,T4,N1,M0: Stage Ⅳaと診断した。CDGP 10 mg iv/body+5-FU 500 mg iv/body; 5連日投与2日休薬/コースとして5コース投与およびradiationを計40 Gy照射した。画像検査では腫瘍は著明に縮小していたが,狭窄は残存したため2004年2月食道亜全摘術を施行した。病理組織学的には明らかな癌細胞の遺残はまったくみられず,治療効果判定はGrade 3 pCRと判断した。補助化学療法は施行しなかったが,術後8年7か月の長期生存中である。
目次
Summary
We report here the long-term survival case of advanced esophageal cancer treated with definitive chemoradiotherapy(CRT). A 61-year-old woman visited our hospital because of a disturbance in her swallowing in September, 2003. She was diagnosed with a middle esophageal type 3 tumor, which was 9 cm in length by endoscopy. Squamous cell carcinoma was diagnosed by pre-operative endoscopic biopsy. CT revealed the tumor with direct invasion to the aorta, and multiple metastases of the lymph nodes(T4, N1, M0: Stage Ⅳa). CRT(combination of 5-FU and nedaplatin with 40 Gy of radiation)was administered. After the completion of CRT, the tumor size was remarkably reduced, but stenosis of the lumen of the esophagus remained partially. Therefore, we performed sub-total esophagectomy in February, 2004. A pathological complete response was diagnosed with no carcinoma cells evident in the resected specimen. Pathological therapeutic evaluation of the esophageal cancer was grade 3. The patient had received no adjuvant chemotherapy, but she is alive and healthy now with no relapse of carcinoma for more than 8 years after operation.
要旨
今回われわれは,進行食道癌に対してcis-diammineglycolatoplatinum(CDGP): Nedaplatin®(CDGP)を使用した化学放射線療法を行った後に手術を施行し,8年以上無再発の症例を経験したので報告する。症例は61歳,女性。嚥下困難で2003年11月当院を受診した。上部消化管内視鏡検査で食道入口部より25 cmのMtに9 cm長の3型腫瘤を指摘され,生検で扁平上皮癌と確定した。CTで腫瘤の大動脈および左房への浸潤が疑われた。原発巣と一塊となったリンパ節も認め,T4,N1,M0: Stage Ⅳaと診断した。CDGP 10 mg iv/body+5-FU 500 mg iv/body; 5連日投与2日休薬/コースとして5コース投与およびradiationを計40 Gy照射した。画像検査では腫瘍は著明に縮小していたが,狭窄は残存したため2004年2月食道亜全摘術を施行した。病理組織学的には明らかな癌細胞の遺残はまったくみられず,治療効果判定はGrade 3 pCRと判断した。補助化学療法は施行しなかったが,術後8年7か月の長期生存中である。