Xian Qing-Ying, Li Xiao-Dong, Zhang Hong-Yu, Wu Jun, Zhu Dan-Xia
Department of Oncology, The Third Affiliated Hospital of Soochow University 185 Juqian Street, Changzhou, Jiangsu Province, P. R. China.
Int J Clin Exp Pathol. 2020 Dec 1;13(12):3181-3186. eCollection 2020.
A 61-year-old male patient was admitted to our hospital with frequent urination, urgency, and increased nocturia for more than 3 months, and the symptoms were aggravated for 1 week. Prostate biopsy revealed prostatic adenocarcinoma. After 5 months, the patient developed dysphagia and gastroscopy showed a middle and lower esophageal cancer (squamous cell carcinoma). 12 months later, he returned to the hospital because of dysphagia. He was examined by gastroscopy which showed the cardia to have low-grade adenocarcinoma. The patient was given Casodex + Zoladex endocrine therapy, zoledronic acid inhibiting bone destruction, concurrent chemoradiotherapy, capecitabinen tablets at a dose of 1000 mg bid, 3 cycles of intravenous paclitaxel at 180 mg/d1 plus cisplatin 60 mg/d1-2, 4 cycles of intravenous paclitaxel at 150 mg/d1 plus cisplatin at 60 mg/d1 as systemic chemotherapy. The curative effect is was considerable after treatment, and the patient's condition was stable. Since the onset of the disease in March 2018, the patient's condition had not progressed significantly for 27 months. The diagnosis and treatment of this patient with ternary cancer in the hospital improved the clinician's understanding of multiple primary cancers. Multidisciplinary treatment improved the patient's prognosis and quality of life. We reviewed similar case reports and retrospective studies of multiple primary cancers and found that there is no specific treatment for multiple primary cancers, but a corresponding treatment program can be formulated for each tumor to control progression while screening for possible other primary tumors.
一名61岁男性患者因尿频、尿急及夜尿增多3个多月入院,症状加重1周。前列腺活检显示为前列腺腺癌。5个月后,患者出现吞咽困难,胃镜检查显示为食管中下段癌(鳞状细胞癌)。12个月后,他因吞咽困难再次入院。胃镜检查显示贲门为低级别腺癌。给予患者康士得+诺雷德内分泌治疗、唑来膦酸抑制骨质破坏、同步放化疗,卡培他滨片剂量为1000mg,每日2次,静脉滴注紫杉醇180mg/d1加顺铂60mg/d1 - 2共3个周期,静脉滴注紫杉醇150mg/d1加顺铂60mg/d1共4个周期作为全身化疗。治疗后疗效显著,患者病情稳定。自2018年3月发病以来,患者病情27个月未明显进展。该患者三元癌在我院的诊断与治疗提高了临床医生对多原发性癌的认识。多学科治疗改善了患者的预后和生活质量。我们回顾了多原发性癌的类似病例报告和回顾性研究,发现多原发性癌没有特异性治疗方法,但可针对每个肿瘤制定相应的治疗方案以控制病情进展,同时筛查可能存在的其他原发性肿瘤。