Kagawa Shunsuke, Fujiwara Toshiyoshi, Nishizaki Masahiko, Tokunaga Naoyuki, Gochi Akira, Tanaka Noriaki
Dept. of Gastroenterological Surgery, Okayama University Graduate School of Medicine and Dentistry.
Gan To Kagaku Ryoho. 2006 Jan;33(1):91-3.
The case is a 74-year-old woman,who underwent curative resection six years earlier for stomach cancer in the cardia extending to the esophagus (Stage IIIA). She noticed hoarseness and cough in September 2004, and CT revealed lymph node metastasis of the cancer in the upper mediastinum. The tumor pressured the SVC, the esophagus,and especially the trachea that narrowed up to a diameter of 5 mm. To secure the air way, first, a self-expandable metallic stent was placed in the narrowed trachea under general anesthesia. Irradiation to the upper mediastinal tumor was further applied for a total of 46 Gy from October to November, 2004. Symptom relief was obtained over the course by a marked reduction in the size of the metastatic tumor, and the disease remained stable for 5 months. In general,a stomach cancer that is mostly adenocarcinoma has been recognized to have low receptivity for radiotherapy. Nevertheless,this case suggests that radiotherapy can play an important role in local control and symptom relief for symptomatic stomach cancer patients.
该病例为一名74岁女性,六年前因贲门部胃癌侵犯食管行根治性切除术(ⅢA期)。2004年9月,她出现声音嘶哑和咳嗽,CT显示上纵隔淋巴结转移癌。肿瘤压迫上腔静脉、食管,尤其压迫气管,气管狭窄至直径5mm。为确保气道通畅,首先在全身麻醉下于狭窄气管内放置自膨式金属支架。2004年10月至11月对上纵隔肿瘤进一步行放射治疗,总量达46Gy。通过转移瘤大小显著缩小,症状逐渐缓解,病情稳定了5个月。一般来说,以腺癌为主的胃癌对放疗的敏感性较低。然而,该病例提示放疗在有症状的胃癌患者的局部控制和症状缓解方面可发挥重要作用。