集学的治療を行った食道小細胞癌の1例 A CASE REPORT OF SMALL CELL CARCINOMA OF THE ESOPHAGUS TREATED WITH MULTIDISCIPLINARY TREATMENT

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切除不能の食道小細胞型未分化癌に対し,化学療法と放射線治療を併用し,主病巣の消失を見た1例を経験したので報告する.症例は77歳女性.嚥下困難と食後の嘔気,嘔吐を主訴に近医を受診し,上部消化管透視にてImEiEaにわたる食道癌と診断され,当科に入院した.内視鏡下生検にて食道小細胞型未分化癌と診断され,諸検査にて左心房,大動脈,左気管支,左胸膜への浸潤を認めたため,胸部食道,縦隔への<sup>60</sup>C<sub>0</sub>照射を総計37.5 Gy, CDDP 50mgと5-FU総量10g併用による全身化学療法を行ったところ,食道透視にて食道病変の完全消失と縦隔への瘻孔形成を認めた.その後患者は,食道気管瘻孔形成による肺炎にて死亡した.食道小細胞癌は診断時すでに広範に転移し,根治切除不能なことが多いが,化学療法の発達による治療有効例の報告も多数見られ,積極的な集学的治療を試みるべきと考える.

We report an inoperable case of small cell carcinoma of the esophagus, which disappeared by multidisciplinary therapies combined with irradiation and chemotherapy. A 77-year-old female underwent an upper gastrointestinal series at another hospital, because she began to develop a dysphagia, postprandial nausea and vomiting. She was referred to the hospital with a diagnosis of cancer of the esophagus extending to the ImEiEa. Fiberscopic biopsy revealed undifferentiated small cell carcinoma of the esophagus. A veriety of examiantions showed that it was a non-resectable cancer of the esophagus, which invaded the left atrium, aorta, left bronchus, and left pleura. She received 37.5 Gy of rediotherapy in total, irradiating to the thoracic esophagus and mediastinum, and chemotherapy consisting in total of CDDP 50mg and 5-FU 10, 000mg. This multidisciplinary therapy caused disappearance of the tumor shadow and fistula formation to the mediastinum on an esophagogram. She died of pneumonia. Small cell carcinomas of the esophagus that tend to metastasize extensively in an early stage at the diagnosis are mostly non-resectable, but we think that aggressive multidisciplinary therapy should be tried for this disease, because there many case reports which were successfully treated by recent effective chemotherapy.

収録刊行物

  • 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society

    日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 57(5), 1120-1124, 1996-05-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008521181
  • NII書誌ID(NCID)
    AN00198696
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    03869776
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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