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一名患有林奇综合征且患多种癌症的患者的ⅠB期恶性胸腺瘤:对偶然给予奥沙利铂和5-氟尿嘧啶的反应

Stage IB malignant thymoma in a Lynch syndrome patient with multiple cancers: response to incidental administration of oxaliplatin and 5-fluorouracil.

作者信息

Tampellini M, Alabiso I, Sculli C M, Barberis M, Giachino D, Berruti A, Dogliotti L

机构信息

Department of Medical Oncology, University of Turin, San Luigi Hospital, Regione Gonzole 10, Orbassano, Italy.

出版信息

J Chemother. 2006 Aug;18(4):433-6. doi: 10.1179/joc.2006.18.4.433.

Abstract

Chemotherapy is active against malignant thymomas, improving the resectability rate and the outcome of the advanced stages. The CAP and ADOC schemes are considered the standard schedules today, but these regimens can have important side effects in patients treated with combined approaches, such as toxic deaths due to congestive heart failure or hepatic insufficiency. We report the case of a 55 year-old woman with a history of multiple neoplasms including a mixed malignant thymoma WHO type B2 and three synchronous adenocarcinomas of the colon. The patient refused to undergo surgical resection of her mediastinal mass. However, 8 cycles of chronomodulated oxaliplatin, 5-fluorouracil and leucovorin as adjuvant treatment for her colon cancers resulted in a > 30% decrease in the longest diameter of the mediastinal mass. This occasional observation may be important for clinicians and especially for those faced with relapsed, cisplatin-refractory disease or when planning new studies aiming to reduce overall toxicity of multimodal schedules.

摘要

化疗对恶性胸腺瘤有效,可提高晚期患者的可切除率及治疗效果。CAP和ADOC方案被认为是目前的标准治疗方案,但这些方案在联合治疗的患者中可能会产生重要的副作用,如因充血性心力衰竭或肝功能不全导致的毒性死亡。我们报告了一例55岁女性患者,她有多种肿瘤病史,包括WHO B2型混合性恶性胸腺瘤和3个同步发生的结肠腺癌。患者拒绝接受纵隔肿块的手术切除。然而,作为结肠癌辅助治疗的8个周期的时辰调节奥沙利铂、5-氟尿嘧啶和亚叶酸钙治疗,使纵隔肿块的最长径缩小了30%以上。这一偶然发现可能对临床医生很重要,尤其是对那些面临复发、顺铂难治性疾病的医生,或在计划开展旨在降低多模式治疗方案总体毒性的新研究时。

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