[Successful management of the recurrent esophageal cancer following esophagectomy at a different time with combined local treatment of chemoradiotherapy and hepatic arterial infusion chemotherapy].
[Successful management of the recurrent esophageal cancer following esophagectomy at a different time with combined local treatment of chemoradiotherapy and hepatic arterial infusion chemotherapy].
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局部放化疗与肝动脉灌注化疗联合局部治疗成功治疗食管癌异期切除术后复发[J].
DOI：
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发表时间：
2008
期刊：
影响因子：
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通讯作者：
K. Kawada
中科院分区：
文献类型：
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作者：
Tomoyoshi Suzuki;Y. Izumi;A. Miura;Tsuyoshi Kato;K. Kawada
1例63岁男性食道癌根治术(CStage III)术后5个月被诊断为腹主动脉旁淋巴结转移。患者接受低剂量氟尿嘧啶(5-FU，CDDP)联合放化疗(CRT)和60Gy射线照射。CRT治疗效果为完全缓解。7个月后，出现肝脏转移(S4)。他接受了全身化疗(5-FU、ADR、CDDP：FAP)，但无效，因此进行了肝动脉插管化疗(FAP)。肝动脉灌注治疗(5-FU 1000 mg/3.5h×ADR 10 mg/1h×顺铂10 mg/1h)，每隔2周治疗1d，疗程18个月。ADR达到最大剂量后，肝动脉注射5-FU(1000 mg/3.5h)和顺铂(10 mg/1h)，每隔4周持续14个月。肝动脉灌注治疗9个月后复发病灶完全消失。患者在手术后69个月仍活着，没有任何复发的迹象。食道癌复发患者多有多处转移，治疗主要以系统治疗为主。然而，在不同时间复发的肿瘤患者中，通过局部治疗以较少的副作用实现完全缓解和长期生存是可能的，就像本病例一样。联合局部治疗可能是食道癌复发患者全身化疗失败后的第二种治疗选择。有必要进行进一步调查。
A 63-year-old man who underwent radical resection for esophageal cancer (cStage III)was diagnosed with metastasis of the paraaortic lymph node 5 months after the surgery. He was treated with concomitant chemoradiotherapy (CRT)with low-dose FP(5-FU, CDDP)and 60 Gy of irradiation. The effect of CRT was a complete response. Seven months later, there was a metastasis to the liver(S4). He received systemic chemotherapy(5-FU, ADR, CDDP: FAP), but it was not effective, so hepatic arterial infusion chemotherapy(FAP)was performed. Hepatic artery infusion therapy( 5-FU 1,000 mg/3.5 h x ADR 10 mg/1 h x CDDP 10 mg/1 h)was given for 1 day at an interval of 2 weeks for 18 months. Since ADR reached the maximum dose, hepatic artery infusion of 5-FU(1,000 mg/3.5 h)and CDDP(10 mg/ 1 h)was continued for 14 months at an interval of 4 weeks. The recurrent lesion disappeared completely 9 months after beginning hepatic artery infusion therapy. The patient is alive 69 months after surgery without any evidence of recurrence. Most cases with recurrent esophageal cancer have multiple metastases, and the treatment is mainly systemic therapy. However, in a patient with recurrent tumors at different times, it is possible to achieve a complete response and long-time survival by local treatment with fewer side effects as in this case. Combined local treatments could be the second treatment option after failed systemic chemotherapy for recurrent tumors in patients with esophageal cancer. Further investigations are necessary.