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[一例晚期乳腺癌伴皮肤溃疡经紫杉醇和托瑞米芬治疗成功治愈的病例]

[A case of advanced breast cancer with skin ulceration successfully treated with paclitaxel and toremifene therapy].

作者信息

Sakurai Kenichi, Fujisaki Shigeru, Matsuo Sadanori, Ogura Michitaka, Enomoto Katsuhisa, Kitajima Akira, Tani Mayumi, Amano Sadao, Shiono Motomi

机构信息

Division of Breast and Endocrine Surgery, Department of Surgery, Nihon University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 2009 Nov;36(12):2484-6.

Abstract

We report a case of advanced breast cancer with skin ulceration and bleeding (T4bN3bM0, Stage IIIC) achieving a significant improvement of QOL by paclitaxel (PTX) and toremifene (TOR) therapy. The patient was a 31-year-old woman who had ulcerative breast lump with skin ulcer. A core needle biopsy for breast tumor led to a diagnosis of an invasive ductal carcinoma positive for estrogen receptor and progesterone receptor, and negative for HER2/neu protein expression. She received 4 courses of tri-weekly CEF (C: 500 mg, E: 60 mg, F: 500 mg/m2/tri-weekly) and 4 courses of weekly PTX (80 mg/m2) with TOR (120 mg/day). The bleeding from the tumor disappeared after CEF chemotherapy. The response for breast tumor after PTX and TOR therapy was evaluated as partial response, and the infraclavicular, subpectoral, and interpectoral lymph nodes metastasis disappeared. Muscle-preserving radical mastectomy (Bt+Ax: Auchincloss) without skin transplantation were performed. She had no recurrence during one year after operation. PTX and TOR therapy were effective for advanced breast tumor, and can improve patient QOL and the clinical outcomes in Stage IIIC advanced breast cancer.

摘要

我们报告一例晚期乳腺癌伴皮肤溃疡和出血(T4bN3bM0,IIIC期)患者,通过紫杉醇(PTX)和托瑞米芬(TOR)治疗,其生活质量得到显著改善。该患者为一名31岁女性,患有溃疡性乳腺肿块并伴有皮肤溃疡。对乳腺肿瘤进行的粗针活检诊断为雌激素受体和孕激素受体阳性、HER2/neu蛋白表达阴性的浸润性导管癌。她接受了4个周期的每三周一次的CEF(C:500mg,E:60mg,F:500mg/m²/每三周一次)以及4个周期的每周一次的PTX(80mg/m²)联合TOR(120mg/天)治疗。CEF化疗后肿瘤出血消失。PTX和TOR治疗后乳腺肿瘤的反应评估为部分缓解,锁骨下、胸小肌下和胸肌间淋巴结转移消失。进行了不进行皮肤移植的保留肌肉根治性乳房切除术(Bt+Ax:Auchincloss术式)。术后一年她无复发。PTX和TOR治疗对晚期乳腺肿瘤有效,可改善IIIC期晚期乳腺癌患者的生活质量和临床结局。

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