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经多学科治疗成功治愈的肛门鳞状细胞癌:DCF化疗后异时性转移和局部复发的病例报告

Squamous cell carcinoma of the anus successfully treated with multidisciplinary therapy for metachronous metastatic and local recurrences after DCF chemotherapy: a case report.

作者信息

Naito Ryozan, Shiraishi Takuya, Hosoi Nobuhiro, Watanabe Takayoshi, Shioi Ikuma, Shibasaki Yuta, Nakazawa Nobuhiro, Osone Katsuya, Okada Takuhisa, Sano Akihiko, Sakai Makoto, Ogawa Hiroomi, Sohda Makoto, Shirabe Ken, Saeki Hiroshi

机构信息

Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-15, Showa-Machi, Maebashi, Gunma, 371-8511, Japan.

出版信息

Surg Case Rep. 2024 Mar 25;10(1):71. doi: 10.1186/s40792-024-01873-2.

Abstract

BACKGROUND

Docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy is reportedly an effective treatment strategy for squamous cell carcinoma of the anus (SCCA). However, studies regarding its use in Japanese patients remain scarce.

CASE PRESENTATION

Here, we present the case of an 82-year-old woman with SCCA, cStage IIIB. Chemoradiotherapy was initiated after colostomy of the anorectal mass; however, para-aortic lymph node recurrence was observed 3 months after treatment completion. Five courses of DCF chemotherapy were subsequently administered, resulting in a complete response (CR). Two years and 1 month later, the aortic lymph node was enlarged again, and the patient achieved CR again after radiotherapy. Nine months later, local recurrence was detected in the anal canal, and laparoscopic perineal rectal amputation was performed. The patient remains progression-free 5 years and 10 months after the initial treatment and 1 year and 7 months after the final treatment.

CONCLUSIONS

Our findings suggest that complementary treatment after DCF chemotherapy may be efficacious in Japanese patients with SCCA and help achieve CR. Despite occasional local recurrences, this approach may help achieve long-term progression-free survival.

摘要

背景

据报道,多西他赛、顺铂和5-氟尿嘧啶(DCF)化疗是肛门鳞状细胞癌(SCCA)的一种有效治疗策略。然而,关于其在日本患者中的应用研究仍然很少。

病例报告

在此,我们报告一例82岁患有IIIB期SCCA的女性病例。在对直肠肛门肿物进行结肠造口术后开始进行放化疗;然而,在治疗完成3个月后观察到腹主动脉旁淋巴结复发。随后给予5个疗程的DCF化疗,结果达到完全缓解(CR)。两年零1个月后,主动脉淋巴结再次肿大,患者在放疗后再次达到CR。9个月后,在肛管发现局部复发,遂行腹腔镜会阴直肠切除术。患者在初始治疗后5年零10个月以及最终治疗后1年零7个月仍无疾病进展。

结论

我们的研究结果表明,DCF化疗后的辅助治疗可能对日本SCCA患者有效,并有助于实现CR。尽管偶尔会出现局部复发,但这种方法可能有助于实现长期无进展生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48af/10963677/93011fdd9011/40792_2024_1873_Fig2_HTML.jpg

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