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采用全身化疗、放疗和莫氏糊剂联合治疗复发性阴茎癌的局部控制成功:病例报告

Successful local control of recurrent penile cancer treated with a combination of systemic chemotherapy, irradiation, and mohs' paste: a case report.

作者信息

Komine Naoki, Narita Shintaro, Kigure Teruaki, Tsuruta Hiroshi, Numakura Kazuyuki, Akihama Susumu, Saito Mitsuru, Inoue Takamitsu, Tsuchiya Norihiko, Satoh Shigeru, Nanjo Hiroshi, Habuchi Tomonori

机构信息

Department of Urology, Akita University School of Medicine, Japan.

Department of Urology, Noshiro Yamamoto Medical Association Hospital, Japan.

出版信息

Case Rep Oncol. 2014 Jul 24;7(2):522-7. doi: 10.1159/000365809. eCollection 2014 May.

Abstract

Penile squamous cell carcinoma (pSCC) is a rare disease, making it difficult to establish a standard of care, particularly in the advanced stage. We report a case of pSCC with advanced lymph node metastasis treated with multimodal therapy consisting of combination chemotherapy, irradiation, and chemosurgery using Mohs' zinc chloride-containing paste. An 80-year-old male with a past history of local treatment for penile cancer presented with a large painful inguinal mass with an ulcer and exudates. The patient underwent multimodal treatment with combination chemotherapy, irradiation, and Mohs' paste. The combination chemotherapy consisted of cisplatin, 5-fluorouracil, and docetaxel. The patient received 50-Gy external-beam radiation therapy to the left inguinal region along with daily local treatment with Mohs' paste. After the initiation of treatment, the pain and bleeding in the inguinal region considerably ameliorated. The wound became dry and flattened 20 days after the initiation of chemotherapy. A CT scan showed that the tumor had decreased 70% in diameter 1 month after the initiation of chemotherapy. After the first course of chemotherapy, the patient and his family decided not to continue treatment because of socio-economic reasons. The patient underwent no additional treatments; nevertheless, he had no local progression of the inguinal tumors for 8 months. We report a case of successful local control of recurrent inguinal pSCC treated with multimodal therapy. Combination treatment with taxane-based chemotherapy, external-beam radiation therapy, and Mohs' paste is an option for the management of recurrent pSCC.

摘要

阴茎鳞状细胞癌(pSCC)是一种罕见疾病,因此难以确立治疗标准,尤其是在晚期。我们报告一例伴有晚期淋巴结转移的pSCC病例,该病例接受了包括联合化疗、放疗以及使用含氯化锌的莫氏糊剂进行化学外科手术的多模式治疗。一名80岁男性,既往有阴茎癌局部治疗史,现出现一个伴有溃疡和渗出物的巨大疼痛性腹股沟肿块。该患者接受了联合化疗、放疗和莫氏糊剂的多模式治疗。联合化疗方案包括顺铂、5-氟尿嘧啶和多西他赛。患者接受了50 Gy的左侧腹股沟区外照射放疗,并每日使用莫氏糊剂进行局部治疗。治疗开始后,腹股沟区的疼痛和出血明显改善。化疗开始20天后伤口变干且变平。CT扫描显示化疗开始1个月后肿瘤直径缩小了70%。在第一个化疗疗程后,由于社会经济原因,患者及其家属决定不再继续治疗。患者未接受其他治疗;然而,其腹股沟肿瘤8个月内未出现局部进展。我们报告一例通过多模式治疗成功实现复发性腹股沟pSCC局部控制的病例。基于紫杉烷的化疗、外照射放疗和莫氏糊剂联合治疗是复发性pSCC治疗的一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eedc/4164061/bf90d8c9c438/cro-0007-0522-g01.jpg

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