Kakudo Yuichi, Yoshioka Takashi, Noguchi Santaro, Hanada Masahito, Otsuka Kazunori, Sakayori Masato, Chiba Natsuko, Shibata Hiroyuki, Kato Shunsuke, Shimodaira Hideki, Ohori Hisatsugu, Takahashi Shin, Takahashi Masanobu, Yamaura Gengo, Yasuda Katsuhiro, Ishioka Chikashi
Dept. of Clinical Oncology, Institute of Development, Aging and Cancer and Tohoku University Hospital, Tohoku University.
Gan To Kagaku Ryoho. 2006 Jul;33(7):969-72.
A 44-year-old man had a tumor in the lower thoracic esophagus at a health check, and was initially diagnosed as an undifferentiated carcinoma of the esophagus by the esophago-gastric endoscope. Although curative chemoradiotherapy was scheduled after the diagnosis, the interim evaluation revealed that the tumor was malignant melanoma of the esophagus with right renal metastasis. Since then, CVD (cisplatin, vindesine and dacarbazine) therapy, palliative radiotherapy and DAC-Tam (dacarbazine, nimustine, cisplatin and tamoxifen) therapy were carried out, but all of them proved ineffective, and multiple newly metastatic lesions appeared in liver and lymph nodes. Oral intake was impossible because of progressing stricture of the esophagus. As a fourth-line therapy, weekly paclitaxel therapy was started, and his oral intake was improved after the second course. He received the therapy as an outpatient for four months. After the third course, tumor lesions were evaluated as a partial response by CT. Consequently, five courses of the therapy were performed with modest adverse effects. Weekly paclitaxel therapy was reasonably safe as reported in other reports and considered to be a promising regimen for malignant melanoma of the esophagus.
一名44岁男性在健康检查时发现下胸段食管有肿瘤，最初经食管胃内镜检查诊断为食管未分化癌。尽管诊断后计划进行根治性放化疗，但中期评估显示该肿瘤为食管恶性黑色素瘤伴右肾转移。从那时起，先后进行了CVD（顺铂、长春地辛和达卡巴嗪）治疗、姑息性放疗和DAC-Tam（达卡巴嗪、尼莫司汀、顺铂和他莫昔芬）治疗，但均证明无效，肝脏和淋巴结出现多个新的转移病灶。由于食管狭窄进展，无法经口进食。作为四线治疗，开始每周一次的紫杉醇治疗，第二疗程后患者的经口进食情况有所改善。他作为门诊患者接受了四个月的治疗。第三疗程后，CT评估肿瘤病灶为部分缓解。因此，共进行了五个疗程的治疗，不良反应较轻。正如其他报道所述，每周一次的紫杉醇治疗相当安全，被认为是治疗食管恶性黑色素瘤的一种有前景的方案。
