一名难治性晚期肾上腺皮质癌患者在接受紫杉醇、卡铂联合米托坦化疗后的长期生存情况。
Long-term survival of a patient with refractory advanced adrenocortical carcinoma after combination chemotherapy with paclitaxel and carboplatin plus mitotane.
作者信息
Kobayakawa Yuki, Hamamoto Shuzo, Kamisawa Hideyuki, Okada Shinsuke, Taguchi Kazumi, Naiki Taku, Okada Atsushi, Tozawa Keiichi, Yasui Takahiro
机构信息
Department of Nephro-Urology Nagoya City University Graduate School of Medical Sciences Nagoya Japan.
Department of Urology Kainan Hospital Yatomi Japan.
出版信息
IJU Case Rep. 2022 Apr 30;5(4):288-292. doi: 10.1002/iju5.12458. eCollection 2022 Jul.
INTRODUCTION
The prognosis of patients with unresectable adrenocortical carcinoma is poor. Mitotane is the first-line treatment for this disease, and etoposide/doxorubicin/cisplatin/mitotane therapy is recommended as first-line chemotherapy in unresponsive cases. We present a case of long-term survival following combination chemotherapy with paclitaxel and carboplatin plus mitotane to manage mitotane-refractory advanced adrenocortical carcinoma.
CASE PRESENTATION
A 49-year-old woman with a left adrenal tumor, lymph node metastasis around the aorta, and multiple liver metastases was treated with mitotane. The disease progressed despite mitotane therapy; thus, combination chemotherapy with paclitaxel and carboplatin plus mitotane was administered for 9 months. Primary adrenal resection was performed after the liver metastasis had completely dissapeared. She has remained alive for 20 years since her initial diagnosis while undergoing mitotane therapy.
CONCLUSION
In this case, combination chemotherapy with paclitaxel and carboplatin plus mitotane effectively controlled advanced adrenocortical carcinoma.
引言
无法切除的肾上腺皮质癌患者预后较差。米托坦是该疾病的一线治疗药物，对于无反应的病例，推荐依托泊苷/阿霉素/顺铂/米托坦疗法作为一线化疗方案。我们报告了一例通过紫杉醇、卡铂联合米托坦治疗米托坦难治性晚期肾上腺皮质癌后长期生存的病例。
病例介绍
一名49岁女性，患有左肾上腺肿瘤、主动脉周围淋巴结转移及多处肝转移，接受了米托坦治疗。尽管进行了米托坦治疗，疾病仍进展；因此，给予紫杉醇、卡铂联合米托坦化疗9个月。在肝转移完全消失后进行了原发性肾上腺切除术。自初次诊断以来，她在接受米托坦治疗的情况下已存活20年。
结论
在此病例中，紫杉醇、卡铂联合米托坦化疗有效控制了晚期肾上腺皮质癌。
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