Itoh H, Watanabe A, Ooka T, Shima I, Hayashi M
Dept. of Internal Medicine, Ishikawa Prefectural Central Hospital.
Gan To Kagaku Ryoho. 1989 Nov;16(11):3631-4.
A case of recurrent breast cancer with metastases to the lung and bone responding well to cisplatin and vindesine in a 45-year-old woman was reported. She had a radical mastectomy for the right breast cancer (pT2N0M0) at 28 years old. She was well until March 1985, when right iliac bone pain appeared. Osteolytic changes were noted on her pelvic roentgenogram. A biopsy obtained from the right iliac bone revealed metastatic adenocarcinoma. She was admitted to our hospital in December 1985 because of chest pain and swelling of the left axillary lymph nodes. Lymph nodes also showed metastatic adenocarcinoma with positive estrogen receptor. Her chest roentgenogram demonstrated a coin lesion in the left hilum and also left pleural effusion. Cytology of the effusion revealed adenocarcinoma. She was first treated with Adriamycin, 5-FU and Cyclophosphamide, but no significant response was noted. But, after two courses of chemotherapy containing cisplatin (80 mg/m2) and vindesine (3 mg/m2), the coin lesion of the lung and pleural effusion disappeared. The osteolytic bone change of the pelvic bone also improved. The serum CEA level decreased from 34.2 ng/ml to 4.2 ng/ml. These results suggest that cisplatin and vindesine were effective for lung and bone cancers metastatic from adenocarcinoma of the breast.
报告了一例45岁女性复发性乳腺癌伴肺和骨转移,对顺铂和长春地辛反应良好的病例。她28岁时因右乳腺癌(pT2N0M0)接受了根治性乳房切除术。直到1985年3月她一直状况良好,当时出现右髂骨疼痛。骨盆X线片显示溶骨性改变。从右髂骨获取的活检显示为转移性腺癌。1985年12月,她因胸痛和左腋窝淋巴结肿大入住我院。淋巴结也显示为转移性腺癌且雌激素受体阳性。她的胸部X线片显示左肺门有一个硬币状病灶以及左胸腔积液。胸腔积液的细胞学检查显示为腺癌。她最初接受阿霉素、5-氟尿嘧啶和环磷酰胺治疗,但未观察到明显反应。但是,在接受了两个疗程含顺铂(80mg/m²)和长春地辛(3mg/m²)的化疗后,肺部的硬币状病灶和胸腔积液消失。骨盆骨的溶骨性改变也有所改善。血清癌胚抗原水平从34.2ng/ml降至4.2ng/ml。这些结果表明顺铂和长春地辛对乳腺癌转移的肺癌和骨癌有效。