Makimoto Go, Fujiwara Keiichi, Watanabe Hiromi, Kameyama Nobuhisa, Matsushita Mizuho, Rai Kammei, Sato Ken, Yonei Toshiro, Sato Toshio, Shibayama Takuo
Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Okayama, Japan.
Case Rep Oncol. 2014 Jan 11;7(1):14-7. doi: 10.1159/000357938. eCollection 2014 Jan.
We present the case of a 40-year-old man with previously treated thymic carcinoma, complaining of gradually worsening back pain. Computed tomography scans of the chest showed multiple pleural disseminated nodules with a pleural effusion in the right thorax. The patient was treated with carboplatin on day 1 plus nab-paclitaxel on day 1 and 8 in cycles repeated every 4 weeks. Objective tumor shrinkage was observed after 4 cycles of this regimen. In addition, the elevated serum cytokeratin 19 fragment level decreased, and the patient's back pain was relieved without any analgesics. Although he experienced grade 4 neutropenia and granulocyte colony-stimulating factor (G-CSF) injection, the severity of thrombocytopenia and nonhematological toxicities such as reversible neuropathy did not exceed grade 1 during the treatment. To our knowledge, this is the first report to demonstrate the efficacy of combination chemotherapy consisting of carboplatin and nab-paclitaxel against thymic carcinoma. This case report suggests that nab-paclitaxel in combination with carboplatin can be a favorable chemotherapy regimen for advanced thymic carcinoma.
我们报告一例40岁男性患者,既往有胸腺癌治疗史,现主诉背痛逐渐加重。胸部计算机断层扫描显示右胸有多个胸膜播散性结节及胸腔积液。患者接受了每4周重复一次的化疗周期,第1天给予卡铂,第1天和第8天给予白蛋白结合型紫杉醇。4个周期的该方案治疗后观察到客观肿瘤缩小。此外,血清细胞角蛋白19片段水平升高有所下降,患者的背痛在未使用任何镇痛药的情况下得到缓解。尽管他出现了4级中性粒细胞减少并接受了粒细胞集落刺激因子(G-CSF)注射,但治疗期间血小板减少的严重程度以及诸如可逆性神经病变等非血液学毒性未超过1级。据我们所知,这是第一份证明卡铂和白蛋白结合型紫杉醇联合化疗对胸腺癌疗效的报告。本病例报告表明,白蛋白结合型紫杉醇联合卡铂可能是晚期胸腺癌的一种良好化疗方案。