この論文を読む／探す
抄録
症例は63歳男性,透析歴は約10年である.左下葉支より左主気管支内腔に突出する扁平上皮癌で,左完全無気肺を呈した.術前補助療法をして放射線照射を1.25×2Gy/day×8日間(20Gy),day3に気管支動脈よりCDDPを73.5mg/m^2注入,人工透析はBAIと同時に開始し,その後2日間は連日でおこなった.著明な腫瘍の縮小効果を認め,左肺摘除術+ND2a郭清を施行した.切除標本では腫瘍のほぼ全体が壊死に陥っており,組織学的効果判定はEf.3であった.慢性腎不全患者でも透析開始時期及び投与方法を工夫すれば健常人とほぼ同量のCDDPを使用でき,放射線との同時療法なども安全に行い得ることを確認した.
The patient was a 63-year-old man who had been on hemodialysis for the past 10 years. The CT scans on admission showed atelectasis of the left lung due to complete obstruction of the left main bronchus with cancer. Induction therapy combined with thoracic irradiation (20Gy) and bronchial artery infusion treatment using CDDP was performed. Hemodialysis was started simultaneously with the infusion of CDDP. Hemodialysis was repeated successively for the first two days after BAI and then returned to a regular hemodialysis. Because the tumor was remarkably reduced in size after treatment, pneumonectomy was performed successfully. Histologically, no viable cells were detected in the resected specimen and the academic effect was judged to be Ef.3. The patient is alive and well 12 months after the operation. Combination chemotherapy and rediotherapy may be a better treatment for lung cancer even in patients with chronic renal failure.
