Araya Tomoyuki, Kita Toshiyuki, Matsuoka Hiroki, Sakai Tamami, Kimura Hideharu, Kasahara Kazuo
Department of Respiratory Medicine, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan.
Department of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan.
Case Rep Oncol. 2020 Dec 17;13(3):1506-1512. doi: 10.1159/000510894. eCollection 2020 Sep-Dec.
A standard chemotherapy regimen for advanced thymic carcinoma has not yet been established. We treated 2 cases of thymic carcinoma with carboplatin plus nanoparticle albumin-bound ()-paclitaxel, and -paclitaxel maintenance therapy. The first case was a 68-year-old female, admitted for dyspnea and left shoulder pain. Chest computed tomography (CT) showed a huge mass in the anterior mediastinum, pleural and pericardial effusions, and multiple lung metastases. Specimens obtained from the anterior mediastinal mass by CT-guided needle biopsy revealed squamous cell carcinoma of the thymus, which was in stage IVB. The patient was administered carboplatin plus -paclitaxel as first-line treatment. After 3 cycles of chemotherapy, a partial response was observed with marked shrinkage of the tumor. Following 6 cycles of chemotherapy, -paclitaxel maintenance therapy was initiated. Disease progression was seen 9.1 months after initiation of treatment. The patient experienced no serious adverse events. The second case was a 70-year-old male who had productive cough, dyspnea, and right-sided chest pain. Chest CT revealed a huge mass in the anterior mediastinum, pericardial effusion, and multiple lymphadenopathies. Specimens obtained from station 11s by endobronchial ultrasound-guided transbronchial needle aspiration revealed undifferentiated thymic carcinoma, which was in stage IVB. Six cycles of carboplatin plus -paclitaxel were administered, followed by 5 cycles of -paclitaxel for maintenance. A partial response was seen, which was sustained for more than 13 months. The patient experienced no serious adverse events. These cases show that chemotherapy with carboplatin plus -paclitaxel and -paclitaxel as maintenance therapy can be a useful regimen for advanced thymic carcinoma.
晚期胸腺癌的标准化疗方案尚未确立。我们用卡铂联合纳米白蛋白结合型()-紫杉醇以及 -紫杉醇维持治疗法治疗了2例胸腺癌患者。第一例是一名68岁女性,因呼吸困难和左肩疼痛入院。胸部计算机断层扫描(CT)显示前纵隔有巨大肿块、胸腔和心包积液以及多处肺转移。通过CT引导下经皮穿刺活检从前纵隔肿块获取的标本显示为胸腺鳞状细胞癌,处于IVB期。该患者接受卡铂联合 -紫杉醇作为一线治疗。化疗3个周期后,观察到部分缓解,肿瘤明显缩小。化疗6个周期后,开始 -紫杉醇维持治疗。治疗开始9.1个月后出现疾病进展。该患者未发生严重不良事件。第二例是一名70岁男性,有咳痰、呼吸困难和右侧胸痛症状。胸部CT显示前纵隔有巨大肿块、心包积液和多处淋巴结肿大。通过支气管内超声引导下经支气管针吸活检从11s区获取的标本显示为未分化胸腺癌,处于IVB期。给予6个周期的卡铂联合 -紫杉醇治疗,随后进行5个周期的 -紫杉醇维持治疗。观察到部分缓解,持续超过13个月。该患者未发生严重不良事件。这些病例表明,卡铂联合 -紫杉醇化疗以及 -紫杉醇维持治疗可能是晚期胸腺癌的一种有效治疗方案。