術前温熱化学放射線療法が著効し組織学的に完全奏功が証明された原発性肺癌の一例(A Case of Lung Cancer with Chest Wall Invasion Showed a Pathologically Complete Response to Preoperative Thermo-chemo-radiotherapy)

K. Terashima, Y. Shioyama, S. Nomoto, Saiji Ohga, Takeshi Nonoshita, Tadamasa Yoshitake, K. Ohnishi, K. Asai, Keiji Matsumoto, Koichi Takayama, Katsumasa Nakamura, Hiromi Terashima, H. Honda
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Abstract

A case of lung cancer with chest wall invasion treated by preoperative thermo-chemo-radiotherapy revealed a histologically complete response after complete resection is reported. A 55-year-old male was diagnosed as primary lung cancer originating from the right upper lobe, cT3N0M0, stage IIB. The tumor invaded the right chest wall accompanied with obstructive pneumonia at its dorsal side and was rapidly growing. Thus, preoperative thermo-chemo-radiotherapy was performed. He was treated with conventional irradiation with a 10 MV X-ray, a total dose of 40 Gy, and concurrent chemotherapy with cisplatin (CDDP) and vinorelbine (VNR). Hyperthermia was applied within 30 min after each radiotherapy with a RF-capacitive heating apparatus (Thermotron RF-8, Ymamamoto Vinyter, Osaka, Japan), 40 min/time, once a week, for a total of 4 times. The tumor revealed necrotic change on CT images after thermo-chemo-radiotherapy and was completely resected. No viable cancer cells were observed in the histological examination (Ef 3). Even 17 months later, there was no recurrence.
术前温热化学放射线疗法有效,组织学证明完全奏效的原发性肺癌一例(A Case of Lung Cancer with Chest Wall Invasion Showed APathologically Complete Response to Preoperative Thermo-chemo-radiotherapy)
本文报告一例肺癌侵袭胸壁术前热化疗放射治疗在完全切除后组织学完全缓解。55岁男性,诊断为原发性肺癌,起源于右上肺叶,cT3N0M0,分期IIB。肿瘤侵犯右胸壁,并伴背侧梗阻性肺炎,生长迅速。因此,术前进行热化疗放疗。患者接受10 MV x线常规照射,总剂量40 Gy,同时联合顺铂(CDDP)和长春瑞滨(VNR)化疗。每次放疗后30分钟内使用射频容性加热装置(Thermotron RF-8, Ymamamoto Vinyter, Osaka, Japan)进行热疗,40分钟/次,每周1次,共4次。经热化疗放疗后,肿瘤在CT上显示坏死改变,并被完全切除。组织学检查未见活的癌细胞(Ef 3),即使在17个月后也未复发。
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