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卡铂和依托泊苷联合放化疗治疗局限期小细胞食管癌:三例病例并文献复习。

Carboplatin and etoposide combined with radiotherapy for limited-stage small-cell esophageal carcinoma: three cases and review of the literature.

机构信息

Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.

出版信息

Jpn J Radiol. 2010 Apr;28(3):181-7. doi: 10.1007/s11604-009-0403-7. Epub 2010 May 1.

Abstract

PURPOSE

Small-cell esophageal carcinoma (SCEC) is a rare disease for which standard therapy has not yet been established. We report the results of three cases of limited-stage SCEC treated with combination therapy using carboplatin (CBDCA) and etoposide (VP-16) and radiotherapy.

MATERIALS AND METHODS

The clinical stage according to the Japanese Classification of Esophageal Cancer 7th ed. was stage III in 2 cases and stage IVa in 1. These patients with limited-stage SCEC were treated at our institution with four cycles of CBDCA and VP-16, either concurrent with radiotherapy for the second two cycles (n = 2) or followed by radiotherapy after the last cycle (n = 1).

RESULTS

A complete response (CR) was obtained for all three patients, resulting in a response rate of 100%. Two patients are alive at 16.4 and 22.5 months after initial treatment. One patient died with myeloid leukemia at 43.5 months after initial treatment. None of the patients had loco-regional recurrence. Brain metastasis was detected in one patient at 7 months after initial therapy and was treated with stereotactic radiotherapy combined with whole brain irradiation.

CONCLUSION

CBDCA and VP-16 in combination with radiotherapy should be considered an important treatment option for SCEC.

摘要

目的

小细胞食管癌(SCEC)是一种罕见疾病,尚未确立标准的治疗方法。我们报告了三例采用顺铂(CBDCA)和依托泊苷(VP-16)联合放疗法治疗局限期 SCEC 的结果。

材料与方法

根据日本食管癌分类第 7 版,临床分期为 2 例Ⅲ期和 1 例Ⅳa 期。这些局限期 SCEC 患者在我院接受 4 个周期的 CBDCA 和 VP-16 联合治疗,其中 2 例与放疗同时进行(第 2 和第 4 周期),1 例在最后一个周期后进行放疗。

结果

所有 3 例患者均获得完全缓解(CR),缓解率为 100%。2 例患者在初始治疗后 16.4 和 22.5 个月时仍存活。1 例患者在初始治疗后 43.5 个月死于骨髓性白血病。所有患者均无局部区域复发。1 例患者在初始治疗后 7 个月出现脑转移,采用立体定向放疗联合全脑照射治疗。

结论

CBDCA 和 VP-16 联合放疗法应被视为 SCEC 的一种重要治疗选择。

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