Department of Clinical Oncology, Sumitomo-Besshi Hospital, Niihama, Japan.
Anticancer Drugs. 2011 Jun;22(5):473-6. doi: 10.1097/CAD.0b013e328344a964.
We describe the case of a 74-year-old male patient with synchronous double primary lung cancers: adenocarcinoma in the right lower lobe and squamous cell carcinoma in the left upper lobe (LUL). These tumors were difficult to differentiate radiographically from a single metastatic primary cancer, but their eventual diagnoses were triggered by their responses to chemotherapy, which included pemetrexed. After two courses of chemotherapy with pemetrexed and carboplatin, the right lower lobe mass had partially resolved; however, the LUL mass had increased. When S-1 was used as fourth-line chemotherapy, the size of the LUL mass decreased. Pemetrexed is a potentially useful drug for treating nonsquamous cell carcinoma, but may not be appropriate in cases with a coexisting squamous cell carcinoma. Our experience with this interesting case leads us to propose that S-1 monotherapy may provide a treatment option in pemetrexed-refractory cases.
我们描述了一例 74 岁男性患者同时患有双原发性肺癌的情况：右下叶腺癌和左上叶（LUL）鳞状细胞癌。这些肿瘤在影像学上很难与单一转移性原发性癌症区分开来，但它们的最终诊断是由于它们对化疗的反应引起的，其中包括培美曲塞。在接受培美曲塞和顺铂的两个疗程化疗后，右下叶肿块部分缓解；然而，LUL 肿块增大。当 S-1 作为四线化疗药物使用时，LUL 肿块的大小减小。培美曲塞是治疗非鳞状细胞癌的一种潜在有效药物，但在合并存在鳞状细胞癌的情况下可能不合适。我们对这一有趣病例的经验使我们提出，S-1 单药治疗可能为培美曲塞耐药病例提供一种治疗选择。
