Kuga Yoshio, Kitamura Shosuke, Mouri Teruo, Miwata Tomohiro, Sakimoto Hideto, Nishida Toshihiro
Dept. of Internal Medicine, Japan Organization of Occupational Health and Safety Chugoku Rosai Hospital.
Gan To Kagaku Ryoho. 2018 Mar;45(3):455-458.
We report a case of resected esophagealcancer that responded wellto first-line combination therapy comprising irinotecan and cisplatin. The patient was a 71-year-old woman being treated for liver cirrhosis. She was admitted to our hospital in April 2015 because of dysphasia. Endoscopic examination revealed a tumor in the mid-thoracic esophagus, which was diagnosed as an endocrine cell carcinoma following pathological examination. Contrast-enhanced computed tomography and positron emission tomography did not show lymph node or distant metastases. She was treated with irinotecan and cisplatin combination therapy. After 6 courses of treatment, the tumor size had remarkably reduced. Subsequently, we performed subtotal esophagectomy and gastric tube reconstruction through the retroposterior mediastinalroute and the histologicaleffect was reported as a partial response. No viable tumor cells were observed in the extracted lymph nodes. However, bone metastasis and lymph node swelling occurred after 4 months. She received other therapeutic regimens, such as etoposide and carboplatin combination therapy. However, the tumor gradually progressed, and she died 18 months after the first treatment. Irinotecan and cisplatin combination therapy is a possible option for the management of esophageal endocrine cell carcinoma as a first-line treatment.
我们报告一例接受一线伊立替康和顺铂联合治疗后反应良好的食管内分泌细胞癌切除病例。患者为一名71岁女性，因肝硬化接受治疗。2015年4月因吞咽困难入住我院。内镜检查发现胸段食管中段有一肿瘤，病理检查后诊断为内分泌细胞癌。增强计算机断层扫描和正电子发射断层扫描未显示淋巴结或远处转移。她接受了伊立替康和顺铂联合治疗。经过6个疗程的治疗，肿瘤大小显著缩小。随后，我们通过后纵隔途径进行了食管次全切除术和胃管重建，组织学结果显示为部分缓解。在切除的淋巴结中未观察到存活的肿瘤细胞。然而，4个月后出现骨转移和淋巴结肿大。她接受了其他治疗方案，如依托泊苷和卡铂联合治疗。然而，肿瘤逐渐进展，首次治疗后18个月死亡。伊立替康和顺铂联合治疗作为食管内分泌细胞癌的一线治疗是一种可行的选择。
