GemcitabineにてQOL改善と延命が得られたび漫性悪性胸膜中皮腫の1例

摘要

び漫性悪性胸膜中皮腫は予後不良の疾患で，手術不能症例の標準的治療法も確立されていない。 様々な抗癌剤を使用したトライアルが行われているが，症例数も少なく有効性が証明された報告はない。近年，非小細胞肺癌に有効と証明されたgemcitabine（GEM）をび漫性悪性胸膜中皮腫に使用し有効であったとの報告が散見される。 われわれも76歳，女性の手術不能二相型悪性胸膜中皮腫にGEMl1，000mg/m2の単剤投与を継続しQOLの改善と2年間の生存を得ることができた。 画像診断上はSD（stable disease）であったが，呼吸困難感，痛みなどの自覚症状の軽減に効果が高かった。GEMは，手術不能び漫性悪性胸膜中皮腫に対しQOL改善などに有効な薬剤となる可能性が示唆された。 Diffuse malignant pleural mesothelioma is a disease with poor prognosis, and no standard therapy for inoperable cases has been established,. There are several reported trials using various anticancer drugs, but their sample sizes were small and none documented the drugs' effectiveness. Recently, some reports revealed that gemcitabine (GEM), which has been demonstrated to be effective for the treatment of non-small cell lung carcinoma, was effective in cases of diffuse malignant pleural mesothelioma,. We also treated a 76-year-old female patient with inoperable, biphasic malignant pleural mesothelioma in whom monotherapy with GEM 1,000mg/m2 was continued leading to improved QOL and survival for 2 years,. Though diagnostic imaging indicated SD (stable disease), a high efficacy was observed in terms of reduced subjective symptoms such as a feeling of difficulty in breathing and pain, It is suggested that GEM is a potentially effective drug for the improvement of QOL in inoperable cases of diffuse malignant pleural mesothelioma.