Verstovsek S, Verschraegen C F, Edwards C L, Malpica A, Kavanagh J J, Ross M I, Strom E A, Jhingran A, Theriault R L, Kudelka A P
Division of Medicine, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Am J Clin Oncol. 2000 Feb;23(1):99-103. doi: 10.1097/00000421-200002000-00026.
Multiple metachronous primary malignancies are becoming increasingly frequent; however, multiple synchronous primary malignancies are still unusual. We report the case of a 61-year-old woman with synchronous stage IIIB ductal carcinoma of the left breast and FIGO stage IB2 squamous cell carcinoma of the cervix. The patient was treated initially every 4 weeks with a 24-h intravenous infusion of paclitaxel (175 mg/m2) followed by a 1-h infusion of carboplatin (area under the curve of 5 mg/ml x min) with concurrent irradiation of the pelvis. Significant toxic reactions including nausea, vomiting, and diarrhea required hospitalization or outpatient intravenous fluids and antiemetics. After four cycles of chemotherapy, the breast cancer was in complete clinical remission, and the patient underwent a modified radical mastectomy with axillary lymph node dissection. Pathologic findings revealed a few microscopic foci of residual infiltrating ductal carcinoma exhibiting a marked treatment effect; none of the 14 axillary lymph nodes removed showed evidence of metastatic tumor. A near-complete pathologic response of the breast cancer and a complete clinical response of the cervical cancer were obtained. Adjuvant chemotherapy for the breast cancer was then initiated, followed by radiation and hormonal therapy.
多发异时性原发性恶性肿瘤越来越常见；然而，多发同时性原发性恶性肿瘤仍然少见。我们报告一例61岁女性患者，其患有左乳同步IIIB期导管癌和国际妇产科联盟（FIGO）IB2期宫颈鳞状细胞癌。患者最初每4周接受一次治疗，静脉输注紫杉醇（175mg/m²）24小时，随后静脉输注卡铂（曲线下面积为5mg/ml·min）1小时，同时进行盆腔放疗。包括恶心、呕吐和腹泻在内的显著毒性反应需要住院治疗或门诊静脉补液及使用止吐药。化疗四个周期后，乳腺癌达到临床完全缓解，患者接受了改良根治性乳房切除术及腋窝淋巴结清扫术。病理结果显示残留浸润性导管癌有一些微小病灶，呈现出显著的治疗效果；切除的14枚腋窝淋巴结均未发现转移瘤证据。乳腺癌获得了近乎完全的病理缓解，宫颈癌获得了完全的临床缓解。随后开始对乳腺癌进行辅助化疗，接着进行放疗和激素治疗。
