[A difficult case of esophageal and gastric double cancer with pleural and pericardial effusion following chemo-radiotherapy (CRT)].
A 70-year-old man was presented with esophageal and gastric cancer pointed by his personal doctor in November 2002. Both of the esophageal and gastric cancer were diagnosed as multiples with cStage II and cStage IA, respectively. In consideration of the patient's quality of life (QOL), chemo-radiotherapy (CRT) for esophageal cancer was preceded, and then total gastrectomy was done. Although esophageal cancer was responded as being complete response (CR), 14 courses of FP therapy were added as supportive chemotherapy. Ten months following CRT, pericardial effusion was noticed, so that pericardiocentesis was performed. Also diuretic has been administered up to the present. Nineteen months following CRT, pleural effusion was noticed and thoracentesis was performed several times into both of the pleural cavities, and that was depending on the degree with OK-432 infusion. Consequently, the patient has been controlled well. As a treatment for esophageal and gastric double cancer, we chose CRT rather than esophagectomy because of the excessive invasiveness. Despite of CR, we have had a difficulty with pleural and pericardial effusions due to the late toxicity of radiotherapy. We need to pay attention to the late toxicity in the case of long-term survival following CRT.
Aoki
Taro
T
Dept. of Surgery, Kinki Central Hospital of Mutual Aid Association of Public School Teachers.
Kobayashi
Kenji
K
Tanida
Tsukasa
T
Hatano
Hisanori
H
Komori
Takamichi
T
Matsumoto
Takashi
T
Nishioka
Kiyonori
K
Uemura
Yoshio
Y
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D010490:Pericardial Effusion / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D010996:Pleural Effusion / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed