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联合化疗加恩度序贯立体定向放疗作为重度呼吸困难复发性食管癌的挽救治疗:1例病例报告及文献复习

Combined chemotherapy plus endostar with sequential stereotactic radiotherapy as salvage treatment for recurrent esophageal cancer with severe dyspnea: A case report and review of the literature.

作者信息

Xu Mingfang, Huang Huan, Xiong Yanli, Peng Bo, Zhou Zejun, Wang Dong, Yang Xueqin

机构信息

Cancer Center, Daping Hospital, Third Military Medical University, Chongqing 400042, P.R. China.

出版信息

Oncol Lett. 2014 Jul;8(1):291-294. doi: 10.3892/ol.2014.2087. Epub 2014 Apr 25.

Abstract

For the majority of inoperable esophageal cancer cases, chemoradiotherapy is the most suitable treatment option. Cetuximab may provide certain benefits, however, this can be an expensive therapy. Additionally, stereotactic body radiation therapy (SBRT) is typically contraindicated for esophageal cancer due to the potential for esophageal perforation and stenosis. The use of combined chemotherapy plus endostar with sequential SBRT for the treatment of esophageal squamous cancer has not been reported. In the current study, the case of a 71-year-old female with esophageal squamous cancer diagnosed 2 years prior is presented. Surgery and four cycles of cisplatin plus 5-fluorouracil chemotherapy had been administered. The patient showed recurrence at the paratracheal lymph node, exhibited severe dyspnea (grade III) and required a semi-liquid diet. Four cycles of the docetaxel, 5-fluorouracil and nedaplatin regimen plus endostar (3 mg; days 1-14; intravenously) with sequential SBRT (3300 cGy in 10 fractions) was administered. Following treatment, the symptoms of the patient completely disappeared, and objective efficacy evaluation indicated complete remission. At the time of writing, the patient is living without discomfort and the progression-free survival is >8 months. In conclusion, the present case indicates that combined treatment of chemotherapy and endostar with sequential stereotactic radiotherapy is a safe and effective option for the management of esophageal cancer.

摘要

对于大多数无法手术的食管癌病例,放化疗是最合适的治疗选择。西妥昔单抗可能会带来一定益处,然而,这种治疗费用昂贵。此外,由于存在食管穿孔和狭窄的风险,立体定向体部放射治疗(SBRT)通常不适用于食管癌。联合化疗加恩度序贯SBRT治疗食管鳞癌的应用尚未见报道。在本研究中,介绍了一例71岁女性食管鳞癌患者,该患者于2年前确诊。此前已接受手术及四个周期的顺铂加5-氟尿嘧啶化疗。患者出现气管旁淋巴结复发,表现为严重呼吸困难(Ⅲ级),需要半流质饮食。给予四个周期的多西他赛、5-氟尿嘧啶和奈达铂方案加恩度(3mg;第1 - 14天;静脉注射)并序贯SBRT(10次分割,共3300cGy)。治疗后,患者症状完全消失,客观疗效评估显示完全缓解。在撰写本文时,患者生活无不适,无进展生存期>8个月。总之,本病例表明化疗联合恩度序贯立体定向放疗是治疗食管癌的一种安全有效的选择。

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