Journal of Digestive Cancer Research

  • 제1권1호
  • /
  • Pages.53-57
  • /
  • 2013
  • /
  • 2950-9394(pISSN)
  • /
  • 2950-9505(eISSN)
대한소화기암연구학회 (Korean Society of Gastrointestinal Cancer Research)
권호 표지

고립성 골 전이를 동반한 식도편평세포암에서 동시 항암화학방사선 요법 후 완전관해를 보인 1례

A Case of Complete Remission after Concurrent Chemoradiotherapy for Esophageal Squamous cell Carcinoma with Solitary Bone Metastasis

  • 이우진 (고려대학교 의과대학 내과학교실) ;
  • 전훈재 (고려대학교 의과대학 내과학교실) ;
  • 김예지 (고려대학교 의과대학 내과학교실) ;
  • 김선영 (고려대학교 의과대학 내과학교실) ;
  • 서민호 (고려대학교 의과대학 내과학교실) ;
  • 최혁순 (고려대학교 의과대학 내과학교실) ;
  • 김은선 (고려대학교 의과대학 내과학교실) ;
  • 금보라 (고려대학교 의과대학 내과학교실) ;
  • 진윤태 (고려대학교 의과대학 내과학교실) ;
  • 이홍식 (고려대학교 의과대학 내과학교실) ;
  • 엄순호 (고려대학교 의과대학 내과학교실) ;
  • 김창덕 (고려대학교 의과대학 내과학교실) ;
  • 류호상 (고려대학교 의과대학 내과학교실)
  • Woo Jin Lee (Department of Internal Medicine, Korea University College of Medicine) ;
  • Hoon Jai Chun (Department of Internal Medicine, Korea University College of Medicine) ;
  • Ye Ji Kim (Department of Internal Medicine, Korea University College of Medicine) ;
  • Sun Young Kim (Department of Internal Medicine, Korea University College of Medicine) ;
  • Min Ho Seo (Department of Internal Medicine, Korea University College of Medicine) ;
  • Hyuk Soon Choi (Department of Internal Medicine, Korea University College of Medicine) ;
  • Eun Sun Kim (Department of Internal Medicine, Korea University College of Medicine) ;
  • Bora Keum (Department of Internal Medicine, Korea University College of Medicine) ;
  • Yoon Tae Jeen (Department of Internal Medicine, Korea University College of Medicine) ;
  • Hong Sik Lee (Department of Internal Medicine, Korea University College of Medicine) ;
  • Soon Ho Um (Department of Internal Medicine, Korea University College of Medicine) ;
  • Chang Duck Kim (Department of Internal Medicine, Korea University College of Medicine) ;
  • Ho Sang Ryu (Department of Internal Medicine, Korea University College of Medicine)
  • 투고 : 2012.10.02
  • 심사 : 2012.11.24
  • 발행 : 2013.03.31
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초록

원격장기 전이를 동반한 식도암 환자에서 아직까지 정립 된 효과적인 치료는 없는 실정이며, 환자의 전신수행능력에 따라 전신 항암화학요법 또는 대증 요법이 시행되고 있다. 저자들은 진단 당시 고립성 골 전이를 동반한 식도암 환자에서 항암화학방사선 요법으로 완전관해를 이룬 드문 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. 57세 남자가 약 2개월 전부터 시작된 진행하는 연하곤란 및 체중감소를 주소로 내원하였다. 환자는 상부 위장관 내시경 검사 및 영상의학적 검사를 통해 5번째 흉추에 고립성 전이를 동반한 식도편평세포암으로 진단되었다. 연하곤란의 완화를 위하여 2달간 항암화학방사선 요법을 계획하였으며, 원발성 식도암 병변에 대한 방사선 조사 범위에 흉추의 골전이 병변이 포함되어 원발성 병변과 함께 흉추에 대해서도 항암화학방사선 요법을 시행하였다. 동시 항암화학요법이 끝난 뒤에 4주기의 추가 항암화학요법을 시행하였다. 추적관찰 전산화 단층촬영 및 양전자방출단층촬영에서 이전에 관찰되었던 원발성 식도암, 식도주변의 림프절 병변 및 흉추의 골 전이 병변은 더 이상 관찰되지 않았으며, 추적 내시경 조직 검사상암세포는 관찰되지 않았다.

There is no established treatment for esophageal carcinoma with metastasis. For the metastatic esophageal squamous cell carcinoma, chemotherapy or best supportive care according to patient's performance status are accepted as an available treatment. We report a case of complete remission after concurrent chemoradiotherapy for esophageal squamous cell carcinoma with metastatic lesion in 5th thoracic vertebrae. A 57-year-old man with ongoing dysphagia and weight loss was admitted to our hospital. On the endoscopic and radiologic imaging evaluation,the patient was diagnosed as a squamous cell carcinoma of esophagus with solitary metastatic lesion in 5th thoracic vertebrae. The patient was treated with combination chemotherapy (5-fluorouracil (5-FU) and cisplatin) and concurrent radiotherapy for two months to relieve dysphagia. Because metastatic lesion in thoracic vertebrae was located near the primary esophageal tumor, the metastatic lesion could be included within the radiation field. After concurrent chemoradiotherapy, consecutive 4 cycles of chemotherapy had been carried out. Primary esophageal tumor with metastatic lymph nodes and metastatic lesion in 5th thoracic vertebrae disappeared on follow up computed tomography (CT) and positron emission tomography-CT (PET-CT). Follow up endoscopic biopsy revealed no remnant malignant cells at previous primary cancer lesion.

키워드

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