Fujiwara K, Maehata K, Kohno I, Yoden E, Imajo Y, Mikami Y
Dept. of Obstetrics and Gynecology.
Gan To Kagaku Ryoho. 2000 Dec;27(14):2259-62.
Clear cell carcinoma of the ovary is believed to be chemoresistant; therefore, choosing anticancer agents is often difficult. In this report we present a case of ovarian clear cell carcinoma that showed a significant response to a combination chemotherapy with paclitaxel and carboplatin. The patient is a 51-year-old Japanese female with a history of Gn-RH treatment for endometriosis that was terminated three years before the presentation of this disease. She was referred to our hospital because of a huge abdominal mass. The initial surgery revealed the tumor was a clear cell carcinoma of the left ovary, showing a predominantly solid growth pattern as well as papillary and tubular patterns. Both architectural and nuclear grades were interpreted as 3, and mitotic count was up to 5/10 high-power fields. Therefore, the tumor was considered to be grade 2. A huge para-aortic lymph node metastasis was not resectable. Combination chemotherapy using paclitaxel at 175 mg/m2 in 3 hr intravenous infusion followed by intraperitoneal infusion of carboplatin at AUC of 7.5 as a bolus was administered. The regression rate of the para-aortic lymph node metastasis was 85%, lasting more than 5 months. We believe that the combination of paclitaxel and carboplatin is one treatment choice for clear cell carcinoma of the ovary.
卵巢透明细胞癌被认为具有化疗耐药性;因此,选择抗癌药物往往很困难。在本报告中,我们展示了一例卵巢透明细胞癌患者,该患者对紫杉醇和卡铂联合化疗表现出显著反应。患者为一名51岁的日本女性,有因子宫内膜异位症接受促性腺激素释放激素(Gn-RH)治疗的病史,在本病出现前三年停止治疗。她因巨大腹部肿块转诊至我院。初次手术显示肿瘤为左卵巢透明细胞癌,主要呈实性生长模式以及乳头状和管状模式。组织学分级和核分级均为3级,有丝分裂计数高达5/10高倍视野。因此,该肿瘤被认为是2级。一个巨大的腹主动脉旁淋巴结转移灶无法切除。采用静脉滴注3小时给予紫杉醇175mg/m²,随后腹腔推注卡铂,使曲线下面积(AUC)为7.5的联合化疗方案。腹主动脉旁淋巴结转移灶的退缩率为85%,持续超过5个月。我们认为紫杉醇和卡铂联合是卵巢透明细胞癌的一种治疗选择。