Hida Kazuhide, Hashimoto Kazunori, Ishitani Ken, Maebayashi Katsuya, Mitsuhashi Norio, Matsui Hideo
Dept. of Obstetrics and Gynecology, Tokyo Women's University.
Gan To Kagaku Ryoho. 2011 Dec;38(13):2639-41.
Malignant peritoneal mesothelioma is extremely rare, and its prognosis is poor. The median survival period is said to be approximately one year after diagnosis. We report a case of recurrent malignant peritoneal mesothelioma treated with concurrent chemoradiotherapy (CCRT). The patient has been alive for six years without recurrence. This report seems to be the first that indicates CCRT to be useful for peritoneal mesothelioma. The patient was a 21-year-old woman who underwent emergency surgery of the in acute abdomen at another hospital. The resected tumor was 18 cm in size and pathological examination revealed that it was a malignant mesothelioma of the epithelioid type. CAP therapy (cyclophosphamide+adriamycine+cisplatin)+CPT-11 administration was given only one course, and the patient was then transferred to our hospital. She underwent resection of the residual disease and six courses of TC therapy (paclitaxel+carboplatin) as adjuvant chemotherapy. Twelve months after chemotherapy, pelvic recurrence occurred. We attempted surgery but only biopsy could be performed because of a pelvic wall invasion. The patient underwent CCRT with weekly cisplatin. The tumor was reduced by irradiation of 50. 4 Gy and disappeared after 6 months. No recurrence has been found six years since the last treatment. CCRT might be effective against malignant peritoneal mesothelioma of the epithelioid type.
恶性腹膜间皮瘤极为罕见，预后较差。据说诊断后的中位生存期约为一年。我们报告一例复发性恶性腹膜间皮瘤接受同步放化疗（CCRT）治疗的病例。该患者已存活六年且无复发。本报告似乎是首例表明CCRT对腹膜间皮瘤有效的报道。患者为一名21岁女性，在另一家医院因急腹症接受了急诊手术。切除的肿瘤大小为18厘米，病理检查显示为上皮样型恶性间皮瘤。仅给予一个疗程的CAP疗法（环磷酰胺+阿霉素+顺铂）+CPT-11治疗，然后患者转至我院。她接受了残留病灶切除术，并接受六个疗程的TC疗法（紫杉醇+卡铂）作为辅助化疗。化疗后12个月，盆腔复发。我们尝试手术，但由于盆腔壁侵犯只能进行活检。患者接受了每周一次顺铂的CCRT治疗。肿瘤经50.4 Gy照射后缩小，并在6个月后消失。自上次治疗以来的六年中未发现复发。CCRT可能对上皮样型恶性腹膜间皮瘤有效。
