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[采用DCF方案全身化疗治疗食管癌术后多发肺及纵隔淋巴结转移的长期完全缓解——病例报告]

[Long-Term Complete Response in Postoperative Multiple Lung and Mediastinal Lymph Node Metastases of Esophageal Cancer Using Systemic Chemotherapy with DCF Treatment - A Case Report].

作者信息

Katsumi Chihiro, Bamba Takeo, Nakagawa Satoru, Aizawa Masaki, Matsuki Atsushi, Yabusaki Hiroshi, Homma Keiichi

机构信息

Dept. of Gastroenterological Surgery, Niigata Cancer Center Hospital.

出版信息

Gan To Kagaku Ryoho. 2017 Jan;44(1):75-78.

Abstract

A 59-year-old man was diagnosed with advanced thoracic esophageal cancer.He underwent neoadjuvant chemotherapy with cisplatin(CDDP), 5-fluorouracil(5-FU)(CF)followed by transthoracic esophagectomy with three-field lymphadenectomy. Histopathological examination revealed that the tumor was poorly differentiated squamous cell carcinoma invading the adventitia with 6 regional lymph node metastases.Four months after surgery, follow-up thoracic computed tomography (CT)showed multiple lung and mediastinal lymph node metastases.The patient's general condition was favorable, and he underwent systemic chemotherapy with docetaxel, CDDP, 5-FU(DCF).After 2 courses of DCF, chest CT revealed that the lung and mediastinal lymph node metastases had markedly decreased in size to the point of being unmeasurable.After receiving additional chemotherapy consisting of 2 courses of DCF and 8 courses of monthly docetaxel, the patient has been followed up without treatment.No tumor re-recurrence has occurred in the 6 years and 8 months since the first recurrence.In cases of recurrent or unresectable esophageal cancer, the rate of clinical response is reported to be higher for DCF than for CF. DCF is a tolerable regimen, even for postoperative patients, provided that monitoring is conducted for severe adverse events. In patients whose general conditions are favorable, DCF should be considered as a treatment option for recurrent esophageal cancer.

摘要

一名59岁男性被诊断为晚期胸段食管癌。他接受了顺铂(CDDP)、5-氟尿嘧啶(5-FU)(CF方案)的新辅助化疗,随后进行了经胸食管癌切除术及三野淋巴结清扫术。组织病理学检查显示肿瘤为低分化鳞状细胞癌,侵及外膜,伴有6个区域淋巴结转移。术后4个月,胸部计算机断层扫描(CT)随访显示多发肺及纵隔淋巴结转移。患者一般状况良好,接受了多西他赛、CDDP、5-FU(DCF方案)的全身化疗。2个疗程的DCF化疗后,胸部CT显示肺及纵隔淋巴结转移灶明显缩小至无法测量。在接受了2个疗程的DCF化疗及8个疗程每月1次的多西他赛化疗后,患者停止治疗并进行随访。自首次复发以来的6年8个月里未出现肿瘤复发。据报道,对于复发或不可切除的食管癌患者,DCF方案的临床缓解率高于CF方案。DCF方案是一种可耐受的治疗方案,即使对于术后患者也是如此,前提是对严重不良事件进行监测。对于一般状况良好的患者,DCF方案应被视为复发性食管癌的一种治疗选择。

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