Makino Tomoki, Hirao Motohiro, Fujitani Kazumasa, Takeda Masashi, Mano Masayuki, Tsujinaka Toshimasa
Dept. of Surgery, National Hospital Organization Osaka National Hospital, Chuo-ku, Osaka, Japan.
Gan To Kagaku Ryoho. 2009 Jul;36(7):1151-4.
A 57-year-old man was admitted to our hospital with dysphagia. Endoscopic examination revealed a wide 0- II c 2/3- circumferential growth with negative iodine staining in the middle-third of the esophagus (25 approximately 32 cm from the incisors). Biopsy examination revealed moderately differentiated squamous cell carcinoma of the esophagus. The depth of invasion was suspected to be not beyond the mucosa (m2), and computed tomography and ultrasonography revealed neither lymph node nor distant metastasis. Esophagectomy or chemoradiation (CRT) was indicated according to the Japanese guidelines for the treatment of esophageal cancer, because endoscopic mucosal resection (EMR) would have been difficult due to the large width of the lesion (2/3 circumferential growth). Chemotherapy was administered with the combined regimen of nedaplatin+adriamycin+5-fluorouracil (NAF) because the patient desired strongly. After completion of two cycles, the cancer lesion disappeared entirely, as determined both clinically and pathologically by endoscopic examination with biopsy, without any major toxicity. At present, 3 years after the chemotherapy, the patient remains free of any evidence of recurrence.
一名57岁男性因吞咽困难入院。内镜检查显示食管中1/3（距门齿约25至32 cm处）有一广泛的0-II c 2/3环周生长病变，碘染色阴性。活检检查显示为食管中分化鳞状细胞癌。怀疑浸润深度未超过黏膜层（m2），计算机断层扫描和超声检查均未发现淋巴结及远处转移。根据日本食管癌治疗指南，因病变宽度较大（环周生长2/3），内镜黏膜切除术（EMR）操作困难，故建议行食管切除术或放化疗（CRT）。由于患者强烈要求，给予顺铂+阿霉素+5-氟尿嘧啶（NAF）联合化疗方案。两个周期化疗结束后，经内镜检查及活检临床和病理判定癌灶完全消失，且无任何严重毒性反应。目前，化疗后3年，患者仍无任何复发迹象。
