Sano T, Saijo N, Sasaki Y, Shinkai T, Eguchi K, Tamura T, Sakurai M, Takahashi H, Nakano H, Tajiri H
Jpn J Cancer Res. 1986 Aug;77(8):790-8.
A 53-year-old man complained of anorexia and abdominal distention of one month's duration. The chest X-ray demonstrated a mass in the left lung with hilar and mediastinal adenopathy and a lytic lesion in the right fourth rib. A transbronchoscopic biopsy of the mass revealed oat cell carcinoma (WHO classification). The endoscopic evaluation also revealed a gastric lesion (IIc type). Biopsy of this lesion indicated signet ring cell gastric cancer. An abdominal CT scan demonstrated multiple liver metastases. Based on these findings, the patient was diagnosed as having synchronous lung and gastric primaries, with liver and bone metastasis from lung cancer. Carboplatin (CBDCA) was administered by intravenous drip infusion of 450 mg/m2. After a second treatment with CBDCA about 3 weeks later, the patient achieved a partial response at the primary site of lung cancer as well as at the liver and bone metastases. In addition, repeat endoscopy of the stomach demonstrated a complete regression. A biopsy specimen taken by gastroscopy was negative for cancer cells. Subsequent chemotherapy for small cell lung cancer was administered with cyclophosphamide, adriamycin, and vincristine, and to date there is no evidence of recurrence. Further studies on CBDCA treatment of small cell lung cancer and gastric cancer are needed to establish the efficacy of this drug against these two histologically different cancers.
一名53岁男性主诉有持续1个月的厌食和腹胀症状。胸部X线显示左肺有一肿块，伴有肺门和纵隔淋巴结肿大，右第四肋骨有一溶骨性病变。对该肿块进行经支气管活检显示为燕麦细胞癌（世界卫生组织分类）。内镜检查还发现胃部有一病变（IIc型）。对该病变进行活检提示为印戒细胞胃癌。腹部CT扫描显示有多处肝转移。基于这些发现，患者被诊断为同时患有原发性肺癌和胃癌，且肺癌已发生肝转移和骨转移。给予卡铂（CBDCA）静脉滴注，剂量为450mg/m²。约3周后进行第二次卡铂治疗后，患者肺癌的原发部位以及肝转移和骨转移灶出现部分缓解。此外，重复进行的胃部内镜检查显示完全消退。胃镜活检标本未发现癌细胞。随后对小细胞肺癌进行化疗，使用环磷酰胺、阿霉素和长春新碱，迄今为止尚无复发迹象。需要对卡铂治疗小细胞肺癌和胃癌进行进一步研究，以确定该药物对这两种组织学不同的癌症的疗效。
