采用旁路手术联合根治性放化疗成功治疗食管癌穿孔
Successful Management of Esophageal Cancer With Perforation Using Bypass Surgery Followed by Definitive Chemoradiotherapy.
机构信息
Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
出版信息
In Vivo. 2020 Jul-Aug;34(4):2169-2172. doi: 10.21873/invivo.12025.
BACKGROUND
Esophageal perforation in advanced esophageal cancer requires immediate treatment. However, no clear treatment protocol has been established for this condition. We report a case of advanced esophageal cancer with esophageal perforation treated with esophageal bypass surgery and definitive chemoradiotherapy (CRT).
CASE REPORT
A 45-year-old woman was diagnosed with locally advanced esophageal cancer with esophageal perforation. Although the patient's general condition was relatively stable, no improvement was expected through conservative treatment. Esophageal gastric bypass surgery was performed; her symptoms improved postoperatively and oral ingestion became possible. Definitive CRT with 66 Gy radiotherapy and chemotherapy with cisplatin and 5-fluorouracil was administered. A complete clinical response was achieved. The patient is alive and well without recurrence 20 months after treatment.
CONCLUSION
Definitive CRT after esophageal bypass surgery is a potential treatment option for locally advanced esophageal cancer with esophageal perforation to improve treatment response and quality of life.
背景
晚期食管癌并发食管穿孔需要立即治疗。然而，对于这种情况尚未建立明确的治疗方案。我们报告了一例晚期食管癌并发食管穿孔，采用食管旁路手术和根治性放化疗（CRT）进行治疗的病例。
病例报告
一名 45 岁女性被诊断为局部晚期食管癌并发食管穿孔。尽管患者的一般情况相对稳定，但保守治疗预计不会有改善。进行了食管胃旁路手术；术后患者症状改善，能够口服进食。给予了 66Gy 放疗和顺铂与氟尿嘧啶联合化疗的根治性 CRT。获得了完全的临床缓解。治疗 20 个月后，患者无复发，生存状况良好。
结论
食管旁路手术后的根治性 CRT 是改善治疗反应和生活质量的一种潜在治疗选择，适用于并发食管穿孔的局部晚期食管癌。
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