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[一例发生心脏转移的乳腺癌患者]

[A Case of a Breast Cancer Patient with Cardiac Metastasis].

作者信息

Konishi Kazuya, Araya Jun, Nagabuchi Makoto, Sakamoto Takashi, Murai Daisuke

机构信息

Dept. of Surgery, Sapporo Century Hospital.

出版信息

Gan To Kagaku Ryoho. 2018 Dec;45(12):1763-1765.

Abstract

The patient was a 65-year-old woman who was diagnosed with Stage III A triple-negative breast cancer(T2N2aM0)at the age of 63. AC chemotherapy(3 months)followed by paclitaxel plus bevacizumab(4 months)was administered as neoadjuvant chemotherapy. After chemotherapy, she underwent mastectomy and lymph node dissection. Pathological examination revealed a partial response. After surgery, radiotherapy with a radiation dose of 50 Gy was applied to the chest wall and supraclavicular lymph node. Multiple pulmonary metastases and mediastinal lymph node metastases were diagnosed 23 months after initial treatment, and she was treated with S-1 administration. Two months after S-1 treatment, the PET-CT showed metastasis in the right atrium. Since there were no cardiac symptoms, S-1 treatment was continued without cardiovascular treatment. However, the mediastinal lymph node metastasis progressed; and therefore, S-1 administration was stopped and chemotherapy with eribulin was initiated. Brain metastasis was diagnosed at the same time and treated with a gamma knife. Although chemotherapy with eribulin was continued, the patient died 33 months after initial treatment owing to the brain metastasis. The cardiac metastasis did not progress during chemotherapy with eribulin. There was no sign of heart failure or arrhythmia during the treatment.

摘要

该患者为一名65岁女性,63岁时被诊断为ⅢA期三阴性乳腺癌(T2N2aM0)。新辅助化疗采用AC化疗(3个月),随后使用紫杉醇加贝伐单抗(4个月)。化疗后,她接受了乳房切除术和淋巴结清扫术。病理检查显示部分缓解。术后,对胸壁和锁骨上淋巴结进行了剂量为50 Gy的放射治疗。初始治疗23个月后诊断出多发肺转移和纵隔淋巴结转移,她接受了S-1治疗。S-1治疗两个月后,PET-CT显示右心房转移。由于没有心脏症状,在未进行心血管治疗的情况下继续S-1治疗。然而,纵隔淋巴结转移进展;因此,停止S-1给药并开始使用艾瑞布林化疗。同时诊断出脑转移并接受了伽马刀治疗。尽管继续使用艾瑞布林化疗,但患者在初始治疗33个月后因脑转移死亡。在使用艾瑞布林化疗期间,心脏转移未进展。治疗期间没有心力衰竭或心律失常的迹象。

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