Hisakane Kakeru, Ohmatsu Hironobu, Umemura Shigeki, Kirita Keisuke, Matsumoto Shingo, Yoh Kiyotaka, Niho Seiji, Goto Koichi
Department of Thoracic Oncology, National Cancer Center Hospital East.
J Nippon Med Sch. 2017;84(5):231-236. doi: 10.1272/jnms.84.231.
Cell-free and concentrated ascites reinfusion therapy (CART) is recognized as a useful treatment to improve the symptoms caused by refractory ascites. Recently, a few clinical studies have reported the effects of CART for malignant ascites, especially in gynecological and gastrointestinal cancers. We report the case of malignant ascites in a patient with malignant pleural mesothelioma (MPM) whose symptoms were relieved by CART. A 59-year-old Japanese male with MPM who had undergone pleural decortication had pleural and peritoneal recurrence. His general status deteriorated as he developed massive ascites due to peritoneal metastases. With the initiation of CART, he recovered well enough to receive cisplatin-based systemic chemotherapy. Repeated use of CART contributed to the maintenance of his good general condition and enabled him to undergo successive systemic chemotherapy, which might have lengthened his life. This is the first report that demonstrates the efficacy of CART for palliative care in a patient with MPM. Our experience indicates that CART should be considered as a treatment option to control refractory malignant ascites regardless of the type of cancer.
无细胞浓缩腹水回输疗法（CART）被认为是改善顽固性腹水所致症状的一种有效治疗方法。最近，一些临床研究报道了CART对恶性腹水的疗效，尤其是在妇科和胃肠道癌症中。我们报告了1例恶性胸膜间皮瘤（MPM）患者的恶性腹水病例，其症状通过CART得到缓解。1例59岁的日本男性MPM患者，曾接受胸膜剥脱术，出现胸膜和腹膜复发。由于腹膜转移，他出现大量腹水，全身状况恶化。随着CART的开始，他恢复良好，足以接受以顺铂为基础的全身化疗。重复使用CART有助于维持他良好的全身状况，并使他能够接受连续的全身化疗，这可能延长了他的生命。这是第一份证明CART对MPM患者姑息治疗有效的报告。我们的经验表明，无论癌症类型如何，CART都应被视为控制顽固性恶性腹水的一种治疗选择。
