Suzuki Nobuyasu, Azami Ayaka, Todate Yukitoshi, Tada Takeshi, Waragai Mitsuru, Honda Michitaka, Sato Atai, Takano Yoshinao, Abe Tsuyoshi, Nakamura Tatsuya, Teranishi Yasushi
Dept. of General Surgery, Southern Tohoku Research Institute for Neuroscience Southern Tohoku General Hospital.
Gan To Kagaku Ryoho. 2017 Jun;44(6):525-528.
We report a case of perianal squamous cell carcinoma and left inguinal lymph node metastasis that showed a complete response more than 5 years after chemotherapy and concomitant proton beam therapy. A 34-year-old woman was referred to our hospital for an anal tumor and a left inguinal tumor. A digital rectal examination revealed a tumor in the anterior wall of the anal canal. In addition, the left inguinal lymph nodes were swollen, leading us to suspect metastases. Biopsy specimens confirmed poorly differentiated squamous cell carcinoma. We made a diagnosis of squamous cell carcinoma T4bN2M0, Stage III b. The patient was treated with chemotherapy consisting of 5-FU(700mg/m / 2/day; continuous intravenous administra- tion)on days 1-5, and CDDP(70mg/m / 2/day)on day 1, along with concomitant proton beam therapy. A total of 45 Gy of X-ray irradiation was administered to the primary lesion, pelvis, and groin area. Furthermore, 24.2 Gy of proton beam therapy was administered to the primary lesion, and 28.6 Gy to the left inguinal lymph nodes. The patient tolerated this treatment with no severe adverse effects. The tumor disappeared completely 1 month after this treatment, and biopsy specimens confirmed the absence of any viable cancer cells. The patient has been alive with no sign of recurrence for 5 years.
我们报告一例肛周鳞状细胞癌伴左腹股沟淋巴结转移患者,经化疗及同步质子束治疗后超过5年显示完全缓解。一名34岁女性因肛门肿物及左腹股沟肿物被转诊至我院。直肠指检发现肛管前壁有肿物。此外,左腹股沟淋巴结肿大,使我们怀疑有转移。活检标本证实为低分化鳞状细胞癌。我们诊断为鳞状细胞癌T4bN2M0,Ⅲb期。患者接受化疗,第1 - 5天给予5 - FU(700mg/m²/天,持续静脉输注),第1天给予顺铂(70mg/m²),同时接受质子束治疗。对原发灶、盆腔和腹股沟区域共给予45Gy的X线照射。此外,对原发灶给予24.2Gy的质子束治疗,对左腹股沟淋巴结给予28.6Gy。患者耐受该治疗且无严重不良反应。治疗1个月后肿瘤完全消失,活检标本证实无存活癌细胞。该患者已存活5年,无复发迹象。