Hiraki Masatsugu, Tanaka Masayuki, Sato Seiji, Kai Keita, Morito Kiyoto, Kobayashi Kiichiro, Noshiro Hirokazu, Tokunaga Osamu, Miyazaki Kohji
Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan.
J Gastrointest Cancer. 2010 Dec;41(4):275-80. doi: 10.1007/s12029-010-9159-7.
Small cell carcinoma of the esophagus (SmCCE) is a rare disease which is considered to be more malignant than the most common types of esophageal cancer. The optimal treatment strategy for this disease still remains controversial. A 69-year-old male was diagnosed to have SmCCE (stage IIIA, T3N1M0). Due to the patient's poor general condition, chemo-radiotherapy consisting of S-1/cisplatin therapy and a total of 60 Gy of radiotherapy was performed. After the treatment, the main lesion completely disappeared while some ulceration remained. A histological examination revealed no viable cancer cells in biopsy specimens obtained by endoscopy. Computed tomographic examinations showed a decreased wall thickness of the esophagus and an improvement in the swelling of the lymph nodes. S-1 monotherapy was administered following the main chemoradiation therapy, and it was performed for a total of 20 courses. The patient has been doing well without recurrence for over 3 years. We judged the effect to be a complete response. This combination chemo-radiotherapy with S-1 and cisplatin may therefore be one of the effective treatments against SmCCE.
食管小细胞癌(SmCCE)是一种罕见疾病,被认为比最常见的食管癌类型恶性程度更高。该疾病的最佳治疗策略仍存在争议。一名69岁男性被诊断为食管小细胞癌(ⅢA期,T3N1M0)。由于患者一般状况较差,遂进行了由S-1/顺铂治疗和总共60 Gy放疗组成的放化疗。治疗后,主要病灶完全消失,但仍有一些溃疡。组织学检查显示,在内镜活检标本中未发现存活癌细胞。计算机断层扫描检查显示食管壁厚度减小,淋巴结肿大情况有所改善。在主要放化疗后给予S-1单药治疗,共进行了20个疗程。患者3年多来情况良好,无复发。我们判断疗效为完全缓解。因此,这种S-1与顺铂联合放化疗可能是治疗食管小细胞癌的有效方法之一。