CarboplatinとPaclitaxelの毎週投与が著効した気管支扁平上皮癌の1例

摘要

carboplatinとpaclitaxelの毎週投与が著効した気管支扁平i皮癌の1例を経験したので報告する。症例は69歳，男性。 66歳時，直腸癌および肝転移に対し低位前方切除術，肝右葉切除術を施行。 胸部CTにて舌区に径2.5cm大の腫癌陰影と肺門縦隔リンパ節の腫大を発見され当科受診。 気管支鏡にて腺癌（直腸癌からの転移）の診断を得た。 同時に右肺にもB 1，B 2入口部をほぼ完全に閉塞する扁平上皮癌を認めた。 N 3の可能性を考慮しcarboplatin（AUC 1.25）とpaclitaxel（70mg/m2）の毎週投与法による化学療法を先行した。 2週施行後の気管支鏡にて右肺腫瘍の著明な縮小を認め，6週終了後には肉眼的に消失した。 また，同部の生検でも悪性所見を認めなかった。 11日後，舌区切除＋肺門縦隔リンパ節サンプリングを施行。 リンパ節転移は認めなかった。 CRが得られてから16か月後の現在，再発認めず外来にて化学療法を続けている。 A 69-year-old man had undergone low anterior resection and a right lobe resection of the liver for rectum cancer and metastatic liver tumor at the age of 66 years, He presented at our hospital because of an abnormal shadow on a CT chest scan, which indicated a tumor shadow 25 cm in size in the lingular lobe and enlarged hilar and mediastinal lymph nodes, A bronchoscopic tumor biopsy revealed pulmonary metastasis from the rectum cancer Bronchoscopic examination also identified an endobronchial squamous cell lung cancer, which almost completely obstructed the orifice of B1 and B2, We concluded that the patient had squamous cell lung cancer with metastases in the mediastinal lymph nodes He was initially treated with weekly chemotherapy with carboplatin (AUC 1,25) and paclitaxel (70 mg/m2).. The endobronchial tumor was markedly reduced in size after 2 weeks of the chemotherapy, Furthermore, after 6 weeks of the chemotherapy, the tumor had dissappeared completely, and 11 days later, lower divison segmentectomy and hilar and mediastinal lymph node dissection were performed. Pathological examination revealed no metastases in the lymph nodes, The patient has continued to receive chemotherapy as an outpatient and has been well without recurrence of any metastases for over 16 months.