Matsuoka Takahisa, Sugi Kazuro, Matsuda Eisuke, Umemori Yoshiki, Okabe Kazunori, Hirazawa Katsutoshi, Azuma Toshitaka
Dept. of Chest Surgery, National Hospital Organization, National Sanyo Hospital.
Gan To Kagaku Ryoho. 2006 Nov;33(11):1625-8.
A 60-year-old man complaining of right shoulder pain and numbness of right arm was diagnosed with Pancoast tumor (invasive right apical lung cancer). Chest CT scan showed a tumor, 5 cm in diameter, in the right apex invading the right posterior chest wall. The patient received preoperative CCRT (RT: 40 Gy/20 Fr, cisplatin: CDDP and etoposide: ETP), resulting in tumor regression (PR). The patient underwent right upper lobectomy (ND 2a), partial resection of the 1st-3rd ribs and Th 1 nerve. Pathological examination demonstrated no live cancer cells and organization of necrotic tissue in the lung and intercostal region (Ef. 3). The patient received postoperative chemotherapy (CDDP+ETP) and was discharged. He did well without any tumor recurrence for 1 year postoperatively. CCRT seems effective and is one of the standard treatments for Pancoast tumor.
一名60岁男性,因右肩疼痛和右臂麻木就诊,被诊断为潘科斯特瘤(右肺尖浸润性癌)。胸部CT扫描显示右肺尖有一个直径5厘米的肿瘤,侵犯右后胸壁。患者接受了术前同步放化疗(放疗:40 Gy/20次,顺铂:CDDP和依托泊苷:ETP),肿瘤缩小(PR)。患者接受了右上叶切除术(ND 2a)、第1 - 3肋骨部分切除术和胸1神经切除术。病理检查显示肺和肋间区域无存活癌细胞,坏死组织机化(Ef. 3)。患者接受了术后化疗(CDDP + ETP)后出院。术后1年患者情况良好,无肿瘤复发。同步放化疗似乎有效,是潘科斯特瘤的标准治疗方法之一。