Kinoshita Hideyuki, Kamoda Hiroto, Ishii Takeshi, Hagiwara Yoko, Tsukanishi Toshinori, Amanuma Yusuke, Nankinzan Rino, Orita Sumihisa, Inage Kazuhide, Hirosawa Naoya, Ohtori Seiji, Yonemoto Tsukasa
Department of Orthopedic Surgery, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba 260-8717, Japan.
Department of Gastroenterology, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba 260-8717, Japan.
Case Rep Orthop. 2020 Feb 6;2020:4753027. doi: 10.1155/2020/4753027. eCollection 2020.
Advanced gastric cancer with bone metastasis has a very poor prognosis with short median survival. To the best of our knowledge, no reports in literature have described extensive recovery of paralysis with multimodality treatment without surgery in these cases. This report describes the case of a 52-year-old severely paralyzed female patient with spinal metastasis from advanced gastric cancer. She was inoperable, owing to a large thrombus in the inferior vena cava; alternative multimodality treatments, including chemotherapy and radiotherapy, were administered. The paralysis and the bladder and rectal dysfunction improved considerably. In addition, the performance status (PS) and Frankel grade also improved dramatically, from 4 to 1 and grade B to D, respectively. At 1 year after initiation of treatment, she is ambulatory. Patients with poor PS are often offered palliative therapy. However, this case demonstrates that poor PS solely due to paralysis from spinal metastasis may necessitate multimodality treatment instead of palliative care.
伴有骨转移的晚期胃癌预后极差，中位生存期短。据我们所知，文献中尚无报告描述在这些病例中未经手术的多模式治疗能使瘫痪得到广泛恢复。本报告描述了一例52岁的晚期胃癌脊髓转移导致严重瘫痪的女性患者。由于下腔静脉存在大血栓，她无法进行手术；于是给予了包括化疗和放疗在内的多模式替代治疗。瘫痪以及膀胱和直肠功能障碍有了显著改善。此外，患者的体能状态（PS）和Frankel分级也分别从4级和B级大幅改善至1级和D级。治疗开始1年后，她能够行走。PS评分低的患者通常接受姑息治疗。然而，该病例表明，仅因脊髓转移导致的瘫痪而PS评分低的患者可能需要多模式治疗而非姑息治疗。
