Takemura Masashi, Osugi Harushi, Lee Shigeru, Nishikawa Takayuki, Fukuhara Kenichiro, Iwasaki Hiroshi
Dept. of Gastroenterological Surgery, Osaka City University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2005 Jul;32(7):1023-7.
We treated a 69-year-old man who had developed esophageal cancer following gastrectomy. Pathologic complete response (pCR) was obtained by neoadjvant chemoradiotherapy using low-dose nedaplatin (CDGP) and 5-fluorouracil. The cancer located in the middle of the thoracic esophagus, had invaded the trachea and metastasized to cervical lymph nodes according to computed tomography. Preoperative chemoradiotherapy combining a low-dose of CDGP with 5-FU was administered together with radiotherapy. Adverse effects included grade 2 stomatitis and leukocytopenia. The esophageal cancer was found by endoscopy to have diminished significantly after completion of neoadjuvant therapy, An endoscopic biopsy specimen was found to contain no malignant cells. The tumor also was smaller by CT, where cervical lymph nodes no longer showed involvement. Partial response was diagnosed based on imaging, and radical resection of the esophageal cancer was performed via right thoracotomy and laparotomy. Operative staging findings indicated Ch x R-T 3 N 0 M 0, Stage II R 0 D 2 Cur A. Pedicled jejunum was used to reconstruct the esophagus through a mediastinal route. Pathologic examination of resected specimens disclosed no viable cancer cells in the esophagus or metastasis to dissected lymph nodes. Neoadjuvant chemoradiotherapy using low-dose CDGP/5-FU is an effective treatment for esophageal cancer.
我们治疗了一名69岁的男性患者,他在胃切除术后患上了食管癌。通过使用低剂量奈达铂(CDGP)和5-氟尿嘧啶进行新辅助放化疗,获得了病理完全缓解(pCR)。根据计算机断层扫描,该癌症位于胸段食管中部,已侵犯气管并转移至颈部淋巴结。术前采用低剂量CDGP与5-FU联合放化疗。不良反应包括2级口腔炎和白细胞减少。新辅助治疗完成后,内镜检查发现食管癌明显缩小,内镜活检标本未发现恶性细胞。CT检查显示肿瘤也变小,颈部淋巴结不再受累。根据影像学诊断为部分缓解,通过右胸切开术和剖腹术对食管癌进行了根治性切除。手术分期结果显示为Ch x R-T 3 N 0 M 0,II期R 0 D 2 Cur A。采用带蒂空肠经纵隔途径重建食管。切除标本的病理检查显示食管内无存活癌细胞,且未转移至清扫的淋巴结。使用低剂量CDGP/5-FU的新辅助放化疗是治疗食管癌的有效方法。