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包括质子束治疗在内的多模态疗法用于治疗伴有多发肝转移的甲胎蛋白分泌型食管癌。

Multimodality Therapy Including Proton Beam Therapy for AFP Producing Esophageal Cancer with Multiple Liver Metastases.

作者信息

Miyazaki Tatsuya, Sohda Makoto, Sakai Makoto, Kumakura Yuji, Yoshida Tomonori, Kuriyama Kengo, Yokobori Takehiko, Miyazaki Masaya, Hirato Junko, Okumura Toshiyuki, Ishikawa Hitoshi, Sakurai Hideyuki, Kuwano Hiroyuki

机构信息

Department of General Surgical Science, Gunma University Graduate School, Japan.

Department of Molecular Pharmacology and Oncology, Gunma University Graduate School, Japan.

出版信息

Intern Med. 2018 Aug 15;57(16):2333-2339. doi: 10.2169/internalmedicine.0270-17. Epub 2018 Mar 30.

DOI:10.2169/internalmedicine.0270-17
PMID:29607947
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6148179/
Abstract

A 50-year-old man who presented with a fever and epigastralgia was diagnosed to have esophageal carcinoma which was identified as poorly differentiated adenocarcinoma producing alpha-fetoprotein (AFP) with Barrett's esophagus. Computed tomography revealed multiple liver metastases and lymph node metastases surrounding the stomach. We first performed chemotherapy for the systemic lesions and proton beam therapy for the local control of lesions without complete remission and we were able to successfully control the frequently recurring lesions by proton beam therapy, cryotherapy and chemotherapy. A complete response has been maintained for 16 months and the overall survival time is 4 years and 2 months. Proton beam therapy for primary esophageal cancer and metastatic lesions was thus found to be an effective therapeutic option for such cases.

摘要

一名50岁男性因发热和上腹部疼痛就诊，被诊断为食管癌，病理检查显示为低分化腺癌，伴有Barrett食管，且能产生甲胎蛋白（AFP）。计算机断层扫描显示肝脏多发转移及胃周围淋巴结转移。我们首先对全身病变进行化疗，并对未完全缓解的局部病变进行质子束治疗，通过质子束治疗、冷冻治疗和化疗成功控制了频繁复发的病变。目前已维持完全缓解16个月，总生存时间为4年2个月。因此，质子束治疗原发性食管癌及转移灶是此类病例的有效治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff22/6148179/e7976aa5d9ad/1349-7235-57-2333-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff22/6148179/21baf526d1cd/1349-7235-57-2333-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff22/6148179/f6f4acff4c59/1349-7235-57-2333-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff22/6148179/adebb72ca38e/1349-7235-57-2333-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff22/6148179/e7976aa5d9ad/1349-7235-57-2333-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff22/6148179/21baf526d1cd/1349-7235-57-2333-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff22/6148179/f6f4acff4c59/1349-7235-57-2333-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff22/6148179/adebb72ca38e/1349-7235-57-2333-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff22/6148179/e7976aa5d9ad/1349-7235-57-2333-g004.jpg

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本文引用的文献

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Proton beam therapy in Japan: current and future status.日本的质子束治疗：现状与未来发展
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Ablation protocols and ancillary procedures in tumor ablation therapy: consensus from Japanese experts.肿瘤消融治疗中的消融方案及辅助程序：日本专家共识
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食管寡转移性腺癌：当前的认识、诊断及治疗策略
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An Extremely Rare Presentation of an Alpha-Fetoprotein-Producing Esophageal Adenocarcinoma.一例极为罕见的产生甲胎蛋白的食管腺癌病例报告
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Oligometastatic Gastroesophageal Adenocarcinoma: Molecular Pathophysiology and Current Therapeutic Approach.寡转移胃食管腺癌：分子病理生理学和当前治疗方法。
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