Toyoda T, Okamoto M, Fujii M, Yonezu S, Kumamoto T, Umemoto M, Saitoh Y, Okamura A
Second Dept. of Internal Medicine, Kohori Hospital.
Gan To Kagaku Ryoho. 1993 Nov;20(14):2235-8.
A 67-year-old man, who was nephrectomized due to renal cell cancer 4 years ago, was admitted to examine a mass shadow in the right middle lung field. He was diagnosed as small cell lung cancer with TBLB. Because of impaired renal function, he was treated with CBDCA (300 mg/m2, day 1), THP (30 mg/m2, day 1) and oral etoposide (25 mg/body, for 21 days) without any renal complications. After 3 courses of chemotherapy, the lung CT showed scar lesion despite the disappearance on the chest X-ray, and a right lower lobectomy was performed. Malignant cells remained in the scar lesion, but not in the lymph nodes. These findings suggested the effectiveness of neoadjuvant chemotherapy. This newly-designed chemotherapy procedure is necessary for patients with renal complications.
一名67岁男性,4年前因肾细胞癌接受了肾切除术,此次因右肺中叶出现团块状阴影入院检查。经经支气管肺活检确诊为小细胞肺癌。由于肾功能受损,给予卡铂(300mg/m²,第1天)、吡柔比星(30mg/m²,第1天)及口服依托泊苷(25mg/体,共21天)进行治疗,未出现任何肾脏并发症。化疗3个疗程后,肺部CT显示有瘢痕病灶,而胸部X线显示病灶消失,遂行右下肺叶切除术。瘢痕病灶中仍有恶性细胞,但淋巴结中未发现。这些结果提示新辅助化疗有效。这种新设计的化疗方案对于有肾脏并发症的患者是必要的。