Chhabra Arpit, Schwartz David, Leaf Andrea, Karanikolas Nikolaos, Weiss Jeffrey P, Schreiber David
Department of Veterans Affairs, New York Harbor Healthcare System, 800 Poly Place, Suite 114A, Brooklyn, NY 11209, USA ; Downstate Medical Center, State University of New York, Brooklyn, NY 11203, USA.
Department of Veterans Affairs, New York Harbor Healthcare System, 800 Poly Place, Suite 114A, Brooklyn, NY 11209, USA.
Case Rep Oncol Med. 2014;2014:479376. doi: 10.1155/2014/479376. Epub 2014 Oct 7.
Introduction. Penile cancer is a rare malignancy often treated with neoadjuvant chemotherapy followed by surgery. However, the utility of neoadjuvant chemoradiation, particularly when the tumor is resistant to chemotherapy alone, has not been established. In this study, we report a case of pT3cN3M0 penile squamous cell carcinoma with progression of nodal disease on chemotherapy, which was cured with use of neoadjuvant concurrent chemoradiation. Case Report. A 65-year-old male presented with a fixed left inguinal lymph node with associated firmness of the penile glans. Biopsies of both sites revealed evidence of squamous cell carcinoma. The patient underwent partial penectomy for the primary lesion and began neoadjuvant chemotherapy to reduce the size of the unresectable left inguinal node. However, he displayed disease progression in the left inguinal node. As such, we attempted concurrent chemoradiation therapy with regression of his nodal disease. The patient was able to undergo left inguinal node dissection and has no evidence of disease 18 months since his initial surgery. Conclusion. The use of neoadjuvant chemoradiation for bulky cN2-3 disease seems appropriate in the setting of progressive disease. Further studies are necessary to assess the utility of concurrent chemoradiation both in the neoadjuvant and salvage setting.
引言。阴茎癌是一种罕见的恶性肿瘤，通常采用新辅助化疗后再进行手术治疗。然而，新辅助放化疗的效用，尤其是当肿瘤对单纯化疗耐药时，尚未得到证实。在本研究中，我们报告了一例pT3cN3M0阴茎鳞状细胞癌患者，其在化疗过程中出现淋巴结疾病进展，经新辅助同步放化疗后治愈。病例报告。一名65岁男性，左侧腹股沟淋巴结固定，伴有阴茎头变硬。两处活检均显示鳞状细胞癌证据。患者因原发性病变接受了部分阴茎切除术，并开始新辅助化疗以缩小无法切除的左侧腹股沟淋巴结大小。然而，他的左侧腹股沟淋巴结出现疾病进展。因此，我们尝试同步放化疗，其淋巴结疾病出现消退。患者能够接受左侧腹股沟淋巴结清扫术，自初次手术以来18个月无疾病证据。结论。在疾病进展的情况下，对体积较大的cN2 - 3疾病使用新辅助放化疗似乎是合适的。需要进一步研究以评估同步放化疗在新辅助和挽救治疗中的效用。
