氣管腺樣囊狀癌為一種罕見疾病,其治療是以手術為主。我們報告一位氣管腺樣囊狀癌的40歲男性病患,經手術、同步化學放射治療(總劑量為64.8Gy,以36分次給予,同時給予每週Cisplatin 30mg/平方公尺)及輔助化學治療(每月給予5-Fluorouracil及Cisplatin)後,短期內卻發現有局部復發及肺部轉移的情形。經肺轉移切除後,開始了以Etoposide及cisplatin為基礎的搶救性化學療法。但是經過3次搶救性化學療法後,疾病依舊持續進展。值得注意的是,稍後卻發現腫瘤對以口服Etoposide及Cisplatin為基礎的節拍式化學治療有良好的反應,且負作用亦不大。在這篇報告中,我們發現對於放射線及化學治療反應不佳的轉移性氣管腺樣囊狀癌,節拍式化學治療或許是一個選擇。
Adenoid cystic carcinoma (ACC) of the trachea is a rare disease and primarily treated with surgery. Here we report a 40 years-old male patient with ACC of the trachea. He was initially treated with surgery, concurrent chemoradiotherapy (delivered with a total dose of 64.8 Gy in 36 fractions concurrently with weekly cisplatin 30 mg/m^2) and adjuvant chemotherapy (monthly 5-fluorouracil and cisplatin). However, local recurrence and lung metastasis developed within a short period. After pulmonary metastatectomy, salvage chemotherapy with etoposide and cisplatin for 3 cycles were given but the disease kept progressing. Intriguingly, metronomic chemotherapy with oral etoposide and cyclophosphamide showed a good tumor response with minimal adverse effect. We reported that metronomic chemotherapy might be an option for the metastatic ACC of the trachea refractory to radiation and chemotherapy.
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