Meyer Andreas, Bruns Frank, Richter Klaus, Grünwald Viktor, Karstens Johann H
Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany.
Anticancer Res. 2007 Mar-Apr;27(2):1047-50.
We report on a rare case of small cell cancer located at the anal canal.
A 41-year old woman presented with locally advanced small cell anal cancer and simultaneous hepatic and pulmonal deposits. Due to metastatic disease, chemotherapy with etoposide and cisplatin was performed with mixed response after four cycles of chemotherapy. After application of two additional chemotherapy cycles, locally progressive disease occurred causing symptomatic bowel obstruction. Pelvic irradiation was started and, several days later, additional irradiation of cerebral metastases was initiated due to rapid progression of distant disease. Despite adequate local treatment the patient's condition further deteriorated and irradiation was stopped. The patient died 10 months after initial diagnosis due to rapid tumor progression.
In patients with metastatic small cell anal cancer chemotherapy remains the mainstay of therapy. Radiotherapy exerts additional activity and remains a prime choice to gain local control and ameliorate symptoms. Careful histopathological examination, together with immunohistochemistry, is needed to determine the therapeutic strategy to be followed.
我们报告一例罕见的位于肛管的小细胞癌病例。
一名41岁女性，患有局部晚期小细胞肛管癌，同时伴有肝脏和肺部转移灶。由于存在转移性疾病，采用依托泊苷和顺铂进行化疗，四个周期化疗后反应不一。在追加两个化疗周期后，出现局部进展性疾病，导致症状性肠梗阻。开始进行盆腔放疗，几天后，由于远处疾病快速进展，开始对脑转移灶进行追加放疗。尽管进行了充分的局部治疗，患者病情仍进一步恶化，放疗停止。患者在初始诊断后10个月因肿瘤快速进展死亡。
对于转移性小细胞肛管癌患者，化疗仍然是主要的治疗方法。放疗具有额外的作用，仍然是实现局部控制和缓解症状的首要选择。需要进行仔细的组织病理学检查并结合免疫组化来确定后续的治疗策略。
