Kubo Norihito, Kawasaki Hitoshi, Takahashi Kentaro, Maruyama Masateru, Miyamoto Keiichi, Wajima Naoki, Hakamada Kenichi
Dept. of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2011 Nov;38(12):2385-7.
We report here a long-term survival case of advanced esophageal cancer with distant lymph node metastases, treated with definitive chemoradiotherapy (CRT). A man in his 60s with disturbance of swallowing was diagnosed as middle esophageal cancer involving multiple metastases of distant lymph nodes. CRT (combination of 5-FU and nedaplatin every four weeks for four courses with 66 Gy of radiation) was administered. After a completion of CRT, CT scan revealed shrinking metastatic lymph nodes. No tumor but a scar at the site of cancer was observed by endoscopy, and histopathology of biopsy specimen detected no tumor cells. From these results, we diagnosed the curative effect of CRT as complete response. Five years after CRT, a swelling of left inguinal lymph node with uptake of fluorine-18-fluorodeoxyglucose appeared and was extirpated, and the swelling was diagnosed histopathologically as metastasis of esophageal cancer. The patient is surviving with no recurrence for 7 years and 8 months from the first diagnosis. In cases of highly advanced esophageal cancer, a long-term follow-up should be performed.
我们在此报告一例晚期食管癌伴远处淋巴结转移经根治性放化疗(CRT)治疗后的长期生存病例。一名60多岁有吞咽障碍的男性被诊断为中段食管癌伴远处淋巴结多处转移。给予CRT(每四周联合应用5-氟尿嘧啶和奈达铂,共四个疗程,放疗剂量为66 Gy)。CRT完成后,CT扫描显示转移淋巴结缩小。内镜检查在癌症部位未见肿瘤,仅见瘢痕,活检标本的组织病理学检查未检测到肿瘤细胞。根据这些结果,我们将CRT的疗效诊断为完全缓解。CRT五年后,左腹股沟淋巴结出现肿胀并摄取氟-18-氟脱氧葡萄糖,予以切除,组织病理学诊断该肿胀为食管癌转移。自首次诊断以来,患者已存活7年8个月且无复发。对于高度进展期食管癌病例,应进行长期随访。