Nedaplatin，5－FU併用化学療法と腔内照射によりCRの得られた進行食道未分化癌の1例

摘要

症例は74歳，女性。 1999年8月に胸部中部食道に1型未分化癌（非小細胞型）を認めた。 T2，N0，Stage Ⅱであったが，多数かつ複雑な既往症や，腎および呼吸器機能障害，歩行障害もありpoor riskによる手術不能例と考えた。 化学療法はnedaplatin 15.8mg/m2および5－FU 590.6mg/m2の5日間連日静脈内投与を行った。 1サイクル後の副作用より2サイクル目はnedaplatinを11.8mg/m2に減量?投与したが，その結果PRを得た。 放射線治療は体外照射の既往状況から追加照射は危険であると判断し，腔内照射を尊独で追加し行った結果CRを得た。 退院後，2年以上の現在CRを維持している。 poor riskかつ悪性度の高い未分化癌に「個別化戦略」が効を奏した1例を報告した。The patient was a 74-year-old female. Type 1 undifferentiated carcinoma (non-small cell type) was detected in the middle of the thoracic esophagus in August 1999, Although the lesion was diagnosed as T2, NO, and Stage II, the patient was judged to be a poor risk, inoperable case because of a complex past history of renal and respiratory dysfunctions, and dysbasia, Intravenous administration of nedaplatin at 15.8 mg/m2 and 5-FU 590.6mg/m2 were carried out for 5 consecutive days as chemotherapy, The second cycle of chemotherapy was performed with nedaplatin reduced to 11.8 mg/m2 on the basis of the adverse reactions observed after the first cycle, and PR was attained. As for radiotherapy, additional extracorporeal irradiation was judged to be too dangerous from her history, so endoesophageal brachytherapy alone was added, and CR was obtained The patient has maintained a CR for more than 2 years after discharge. In this poor risk case with a highly malignant undifferentiated carcinoma, an "individualization strategy" was effective.