[A case of stage IV advanced esophageal cancer with a long term survival by radiation therapy combined with nedaplatin and 5-FU chemotherapy].
The patient was a 73-year-old man who complained of dysphagea. Various examinations revealed an esophageal cancer with direct invasion to the left main bronchus (cT4, N2 (104R, 106recR), M0, Stage IVa) and gastric cancer (cT2, N0, M0, Stage IB). The patient was given preoperative chemoradiotherapy (40 Gy/20 fr with CDGP 10 mg/body day 1-5, 8- 12, 15-19 and 5-FU 250 mg/body day 1-5, 8-12, 15-19). After the chemoradiotherapy, we estimated that the esophageal cancer was down stage (cT4-->T3), and that a curative operation was possible. Therefore, subtotal esophagectomy and partial gastrectomy were performed without a complication. Pathological therapeutic evaluation of the esophageal cancer was complete response (CR) and the gastric cancer was T2, N0. Adjuvant chemotherapy was undergone with S-1. However, two years after the first operation, we found a recurrence of gastric duct. Therefore a surgical resection for recurrence of gastric duct was performed. The patient is still alive without recurrence 5 years and 2 months after the first treatment. Radiation therapy combined with nedaplatin and 5-FU is a safe and effective method for treating cT4 advanced esophageal cancer.
Morimoto
Junya
J
Department of Surgical Oncology, Osaka City University Graduate School Division of Medicine.
Oohira
Masaichi
M
Kubo
Naoshi
N
Tanaka
Hiroaki
H
Dan
Nobuhiro
N
Muguruma
Kazuya
K
Yashiro
Masakazu
M
Sawada
Tetsuji
T
Yamashita
Yoshito
Y
Nishiguchi
Yukio
Y
Hirakawa
Kousei
K
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D016629:Esophagectomy; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000628:therapy; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000473:pathology
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; C053989:nedaplatin; D005472:Fluorouracil