局部晚期默克尔细胞癌的新辅助多药化疗
Neoadjuvant polychemotherapy in locally advanced Merkel cell carcinoma.
作者信息
Jouary Thomas, Lalanne Nathalie, Siberchicot François, Ricard Anne-Sophie, Versapuech Julie, Lepreux Sébastien, Delaunay Michèle, Taieb Alain
机构信息
Dermatology Department, Skin Cancer Unit, St André's Hospital, Bordeaux, France.
出版信息
Nat Rev Clin Oncol. 2009 Sep;6(9):544-8. doi: 10.1038/nrclinonc.2009.109.
BACKGROUND
A 72-year-old man presented with a Merkel cell carcinoma (MCC) of the left cheek with concomitant nodal spread. A 61-year-old man presented with an MCC of the right thigh with rapid nodal recurrence.
INVESTIGATIONS
Skin biopsy samples proved the MCC nature of the neoplasm in both patients. Staging procedure included clinical and radiological investigations.
DIAGNOSIS
Advanced stage II MCC.
MANAGEMENT
Neoadjuvant cisplatin, etoposide and cyclophosphamide (EPC) regimen led to local control in the first patient and allowed curative surgery associated with adjuvant radiation therapy. Complete remission was maintained for 32 months. The second patient was treated by surgery plus radiation therapy. Nodal and cutaneous recurrences were treated with a neoadjuvant EPC regimen leading to a 5-year complete remission.
背景
一名72岁男性患者，左脸颊患有默克尔细胞癌（MCC）并伴有淋巴结转移。一名61岁男性患者，右大腿患有MCC且淋巴结快速复发。
检查
皮肤活检样本证实两名患者的肿瘤均为MCC性质。分期程序包括临床和放射学检查。
诊断
II期晚期MCC。
治疗
新辅助顺铂、依托泊苷和环磷酰胺（EPC）方案使首例患者实现了局部控制，并允许进行与辅助放疗相关的根治性手术。完全缓解维持了32个月。第二例患者接受了手术加放疗。淋巴结和皮肤复发采用新辅助EPC方案治疗，实现了5年完全缓解。
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