Tezuka Koji, Inaba Yukio, Hayashi Ken-ichi, Miura Takuya, Moriya Toshiyuki, Takiguchi Makoto, Isobe Hideki, Watabe Shuichi, Yanagawa Naoki
Dept. of Surgery, Yamagata Prefectural Kahoku Hospital.
Gan To Kagaku Ryoho. 2007 Oct;34(10):1709-12.
We report a case on hemodialysis with liver metastases from anorectal malignant melanoma treated by dacarbazine (DTIC). A 61-year-old man presented with anal bleeding. An elastic soft mass was palpated in the anal canal, and a biopsy specimen was diagnosed as anorectal malignant melanoma histologically. After introducing hemodialysis for the chronic renal failure, abdominoperineal resection was performed. Two and a half years after surgery, computed tomography showed multiple liver metastases. We chose chemotherapy consisting of DTIC 100 mg for five consecutive days every 4 weeks in addition to hemodialysis (3 times a week). After three cycles of chemotherapy, liver metastases were stable, but new lung metastases were found. After 12 cycles of chemotherapy, liver metastases became stable, but lung metastases were progressive. Subsequently, the patient died of respiratory failure 4 years after surgery, 1 year and 7 months after the diagnosis of multiple liver metastases. No severe toxicity was observed during this period. We conclude that administration of DTIC undergoing hemodialysis for malignant melanoma with renal failure seems to be useful without severe adverse events.
我们报告了一例接受达卡巴嗪(DTIC)治疗的伴有肝转移的肛管恶性黑色素瘤患者进行血液透析的病例。一名61岁男性出现肛门出血。在肛管可触及一个弹性柔软肿物,活检标本经组织学诊断为肛管恶性黑色素瘤。在因慢性肾衰竭开始血液透析后,进行了腹会阴联合切除术。术后两年半,计算机断层扫描显示多发肝转移。除每周3次血液透析外,我们选择每4周连续5天给予100 mg DTIC的化疗方案。三个化疗周期后,肝转移稳定,但发现了新的肺转移。12个化疗周期后,肝转移稳定,但肺转移进展。随后,患者在术后4年、诊断多发肝转移后1年7个月死于呼吸衰竭。在此期间未观察到严重毒性反应。我们得出结论,对于伴有肾衰竭的恶性黑色素瘤患者,在进行血液透析的同时给予DTIC似乎有效且无严重不良事件。