子宮頸癌之新輔助化學治療和肋膜內cisplatin治療：一病例報告

新輔助化學治療乃一種新的治療方式，其定義為在決定性的治療進行前先給予化學治療數次。在局部晚期之子宮頸癌患者，首先給予抗癌藥物，有可能將腫瘤之體積減少，且可能降低淋巴結之轉移，因此也許能以手術來切除治療。我們報告一第二期b之子宮頸癌患者，經過以vincristine， bleomycin和cisplatin之新輔助化學治療三次療程後，得到部份有效反應，患者再接受廣泛性手術治療。組織標本中在子宮頸上見到一2.2 x 1cm之殘餘腫瘤，因此，在手術後繼續以cisplatin和vincristine作化學治療。不幸的是患者後來發生肋膜積水和多處遠處轉移。以cisplatin和bleomycin注入肋膜中作化學治療，得到部份有效反應。最後，雖然積極的給予化學治療，包括ifosfamide和etoposide，用作救援治療，患者仍於診斷後13個月死亡。在台灣，似乎沒有以cisplation作肋膜積水治療之報告，本文可能為首例。

關鍵字

新輔助化學治療；肋膜腔內化學治療；子宮頸癌

並列摘要

Neoadjuvant chemotherapy is a new modality to give cytotoxic agents first to reduce tumor bulk as well as potentially eliminate nodal metastases, then surgery is conducted to remove the locally advanced cancer. We described a case of stage-IIb cervical cancer. After 3 courses of neoadjuvant chemotherapy consisting of vincristine, bleomycin and cisplatin regimen, partial response was observed. Then the patient underwent radical surgery. Histological specimen revealed a 2.2 x 1cm residual tumor in the cervix. Therefore, additional chemotherapy with cisplatin and vincristine was given continuously.Unfortunately, the patient developed pleural effusion and multiple distant metastases. Intrapleural chemotherapy with cisplatin and bleomycin was administered to evidence partial response. Finally, despite aggressive chemotherapy containing ifosfamide and etoposide was used as salvage therapy, the patient expired 13 month after diagnosis. There seems to be no previous report on the use of cisplatin to treat pleural effusion in Taiwan, this paper may be the first one.

並列關鍵字

neoadjuvant chemotherapy ； intrapleural chemotherapy ； cervical cancer

國際替代計量

子宮頸癌之新輔助化學治療和肋膜內cisplatin治療：一病例報告

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