Gunjigake Katsuya, Okamoto Koichi, Gabata Ryosuke, Yamaguchi Takahisa, Ninomiya Itasu, Fushida Sachio, Ohta Tetsuo
Dept. of Gastroenterological Surgery, Graduate School of Medical Science, Kanazawa University.
Gan To Kagaku Ryoho. 2019 Jan;46(1):61-63.
Docetaxel, cisplatin, and 5-FU(DCF)chemotherapy for esophageal cancer has been reported to be highly effective, but often causes serious adverse events, including severe bone marrow suppression. We report the successful treatment of a 67- year-old man with highly advanced esophageal cancer with invasion of the left bronchus and broad lymph node metastases. He received induction chemotherapy with DCF therapy, and prophylactic administration of pegfilgrastim. He safely completed 5 courses of DCF therapy without serious adverse events, such as neutropenia and febrile neutropenia. The size of the primary tumor and lymph node metastases remarkably reduced after the third course of DCF. He underwent thoracoscopic esophagectomy with three-field lymph node dissection and reconstruction with a gastric tube. The pathological findings of the resected specimen showed no viable malignant cells in the primary lesion and the pathological effect after chemotherapy was judged as Grade 3. Viable cancer cells still remained in 10 lymph nodes in the dissected field. DCF therapy with prophylactic administration of pegfilgrastim may be an effective and safe treatment for advanced esophageal cancer.
据报道，多西他赛、顺铂和5-氟尿嘧啶（DCF）化疗方案治疗食管癌疗效显著，但常引发严重不良事件，包括严重骨髓抑制。我们报告了1例67岁患有高度进展期食管癌且侵犯左支气管并伴有广泛淋巴结转移的男性患者的成功治疗案例。他接受了DCF诱导化疗，并预防性使用了聚乙二醇化重组人粒细胞刺激因子。他安全地完成了5个疗程的DCF治疗，未出现严重不良事件，如中性粒细胞减少和发热性中性粒细胞减少。在DCF治疗的第三个疗程后，原发肿瘤和淋巴结转移灶的大小显著缩小。他接受了胸腔镜下食管癌切除术及三野淋巴结清扫术，并采用胃管进行重建。切除标本的病理检查结果显示，原发灶无存活癌细胞，化疗后的病理疗效判定为3级。在清扫区域的10个淋巴结中仍有存活癌细胞。预防性使用聚乙二醇化重组人粒细胞刺激因子的DCF治疗可能是晚期食管癌的一种有效且安全的治疗方法。
