[Effective chemo-endocrine combination therapy for obstructive-jaundice caused by multiple liver metastasis of recurrent breast cancer--a case report].
A 68-year-old woman complained of obstructive jaundice 9 years after a radical mastectomy. CT scan demonstrated multiple metastasis of the liver and two coin lesions of the right lung. The biliary tract was completely obstructed at the portal fissure. Multiple liver and lung metastasis of breast cancer were diagnosed because of high CA 15/3 serum levels and normal gastrointestinal study. Following unsuccessful treatment with tamoxifen (TAM), we used toremifene (TORE) and 5'-deoxy-5-fluorouridine (5'-DFUR) followed by percutaneous transhepatic cholangiodrainage (PTCD). The biliary tract was reopening and jaundice disappeared with improvement of the general condition. Then endocrine therapy with medroxy progesterone acetate and UFT and chemotherapy with CAF (Cyclophosphamide, Adriamycin, 5-FU) were begun. A partial response (PR) was obtained with the disappearance of liver metastasis and two coin lesions of the lung 5 months after the first treatment. The effect of chemo-endocrine combination therapy continued for 5 months. Survival time from recurrence was 13 months. In our case, PR was obtained by using chemo-endocrine combination therapy, although a poor prognosis has been reported in patients with obstructive jaundice caused by multiple liver metastasis of recurrent breast cancer.
Dept. of Surgery, Imai Hospital.
K
K
Hoshino
M
M
Nakamura
H
H
Ikeda
T
T
Koyama
Y
Y
Morishita
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D002779:Cholestasis / Q000209:etiology / Q000628:therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004322:Drainage / Q000379:methods; D005260:Female; D005467:Floxuridine / Q000008:administration & dosage; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D015409:Mastectomy, Radical; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D013629:Tamoxifen / Q000008:administration & dosage; D005641:Tegafur / Q000008:administration & dosage; D017312:Toremifene / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage
D018931:Antineoplastic Agents, Hormonal; D005467:Floxuridine; D013629:Tamoxifen; D005641:Tegafur; D014498:Uracil; D017312:Toremifene; D004317:Doxorubicin; D003520:Cyclophosphamide; D017258:Medroxyprogesterone Acetate; D005472:Fluorouracil; C025034:doxifluridine