Kondo Rie, Watanabe Satoshi, Ishikawa Daisuke, Tanaka Tomohiro, Ohshima Yasuyoshi, Asakawa Katsuaki, Sakagami Takuro, Okajima Masaaki, Miura Satoru, Hayashi Yoshiki, Tanaka Junta, Kagamu Hiroshi, Yoshizawa Hirohisa, Narita Ichiei
Dept. of Internal Medicine II, Niigata University Medical and Dental Hospital.
Gan To Kagaku Ryoho. 2014 Dec;41(13):2607-9.
A 65-year-old woman with left chest pain, back pain, and palpitation that had persisted for 2 months was referred to our hospital. Computed tomography of her chest showed an anterior mediastinal tumor with mediastinal lymphadenopathy, left pleural effusion, and pericardial effusion. Endobronchial ultrasound-guided transbronchial needle aspiration of the subcarinal lymphadenopathy was performed. The pathological findings and other examinations such as bone scintigraphy suggested advanced thymic cancer (stage IV b according to the Masaoka classification of thymic epithelial tumors). The patient was treated with combination chemotherapy of carboplatin(area under the curve [AUC]=6, 656 mg/body, day 1) and weekly paclitaxel (70 mg/m², 100 mg/body, days 1, 8, and 15). After 4 cycles of chemotherapy, a partial response was achieved and the pericardial effusion disappeared. The patient did not experience any severe toxicity, except for grade 1 nausea, grade 2 anemia, and grade 2 alopecia. Weekly paclitaxel combined with carboplatin appears to be a useful regimen with minimal toxicity for advanced thymic cancer.
一名65岁女性因左胸痛、背痛和心悸持续2个月而转诊至我院。胸部计算机断层扫描显示前纵隔肿瘤伴纵隔淋巴结肿大、左侧胸腔积液和心包积液。对隆突下淋巴结肿大进行了支气管内超声引导下经支气管针吸活检。病理结果及骨闪烁显像等其他检查提示为晚期胸腺癌(根据胸腺瘤上皮肿瘤的Masaoka分类为IV b期)。患者接受了卡铂(曲线下面积[AUC]=6,656mg/体,第1天)和每周一次紫杉醇(70mg/m²,100mg/体,第1、8和15天)的联合化疗。化疗4个周期后,获得部分缓解,心包积液消失。除1级恶心、2级贫血和2级脱发外,患者未出现任何严重毒性反应。每周一次紫杉醇联合卡铂似乎是一种对晚期胸腺癌毒性最小的有效方案。