Matsutani Takeshi, Yoshida Hiroshi, Sasajima Koji, Maruyama Hiroshi, Yokoyama Tadashi, Matsushita Akira, Hirakata Atsushi, Takao Yoshimune, Umakoshi Michinobu, Hayakawa Tomohiro, Katayama Hironori, Hosone Masaru, Uchida Eiji
Dept. of Surgery,Nippon Medical School Tama-Nagayama Hospital.
Gan To Kagaku Ryoho. 2012 Apr;39(4):645-8.
A 72-year-old male with a chief complaint of dysphagia was admitted to our hospital. Upper gastrointestinal endoscopic examination showed double cancers with thoracic esophageal cancer in the middle esophagus and gastric cancer in the antrum. Pathological examinations of the double cancer revealed the first one to be moderately-differentiated squamous cell carcinoma and the second to be well-differentiated adenocarcinoma. Computed tomography (CT) of the chest and abdomen showed no distant or lymph node metastases. Clinical stagings of the double cancer were stage II (T2N0M0)in esophageal cancer and stage I A (T1N0M0) in gastric cancer. The patient received neoadjuvant chemotherapy using docetaxel, CDDP and 5-FU. After 2 courses of chemotherapy, the adverse event was grade 2 in leucopenia and grade 2 in alopecia. Repeated macroscopic and histological examinations after chemotherapy revealed that the esophageal cancer had significant reductions in the size of tumors, leading to a partial response, and the gastric cancer had disappeared, leading to a complete response. He underwent thoracoscopy-assisted esophagectomy in the prone position, and laparoscopy-assisted gastric tube reconstruction. This neoadjuvant chemotherapy of docetaxel, CDDP and 5-FU might be effective and tolerable as with patients with double cancer of esophageal and gastric cancers.
一名以吞咽困难为主诉的72岁男性入住我院。上消化道内镜检查显示为双原发癌，中段食管癌和胃窦部胃癌。双原发癌的病理检查显示，第一个为中分化鳞状细胞癌，第二个为高分化腺癌。胸部和腹部计算机断层扫描（CT）显示无远处转移或淋巴结转移。双原发癌的临床分期为食管癌II期（T2N0M0），胃癌IA期（T1N0M0）。患者接受了多西他赛、顺铂和5-氟尿嘧啶的新辅助化疗。化疗2个疗程后，不良事件为白细胞减少2级，脱发2级。化疗后反复进行的宏观和组织学检查显示，食管癌肿瘤大小显著减小，达到部分缓解，胃癌消失，达到完全缓解。他在俯卧位接受了胸腔镜辅助食管切除术，并在腹腔镜辅助下进行胃管重建。多西他赛、顺铂和5-氟尿嘧啶的这种新辅助化疗对于食管和胃癌双原发癌患者可能是有效且可耐受的。
