Hikino Hajime, Yamada Takako, Johbara Kanta, Obayashi Nobuhiko, Ozaki Nobuhiro
Department of Surgery, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, Shimane 6938555, Japan.
Breast. 2006 Feb;15(1):97-9. doi: 10.1016/j.breast.2005.03.006. Epub 2005 Jul 7.
A 54-year-old woman underwent mastectomy and axillary lymph node dissection for infiltrating ductal carcinoma with multiple lymph node involvement. The patient received adriamycin 60 mg/m(2) and cyclophosphamide 600 mg/m(2) (AC) followed by weekly paclitaxel 80 mg/m(2) and external irradiation to the local lymph node regions as adjuvant treatment. After 1 year and 5 months, the patient suffered her first recurrence, developing multiple brain and meningeal metastases. CNS involvement was well controlled by oral capecitabine (2400 mg twice daily, on days 1-21 of a 28-day cycle) and external whole brain irradiation of 50 Gy with minimal toxicity. We suggest that capecitabine contributed to the favorable clinical course in this patient and believe that, as an oral agent, this drug may benefit patients with CNS metastases of breast cancer by allowing home-based therapy.
一名54岁女性因浸润性导管癌伴多枚淋巴结受累接受了乳房切除术和腋窝淋巴结清扫术。患者接受了阿霉素60mg/m²和环磷酰胺600mg/m²（AC方案）治疗，随后每周接受紫杉醇80mg/m²治疗，并对局部淋巴结区域进行外照射作为辅助治疗。1年零5个月后，患者首次复发，出现多发脑和脑膜转移。通过口服卡培他滨（28天周期的第1 - 21天，每日两次，每次2400mg）和50Gy的全脑外照射，中枢神经系统受累得到了良好控制，且毒性极小。我们认为卡培他滨促成了该患者良好的临床病程，并相信作为一种口服药物，该药可使乳腺癌中枢神经系统转移患者受益，实现居家治疗。
