- 期刊
Remission of Clubbing Fingers after Chemoradiotherapy in a Patient with Locally Advanced Non-small Cell Lung Cancer
非小細胞肺癌病患接受化學治療後，杵狀指的明顯消散
摘要
杵狀指是一個臨床常見的現象，通常是在肺部或心臟疾病中的病人表現。這種情況並非罕見，可發生在所有細胞類型的肺癌[1]。導致杵狀指的確切機轉還沒有完全理解。在某些研究報告指出，肺癌切除後會看到杵狀指的改善[2]。至於肺癌接受化學治療或放射治療後，杵狀指的改善的報導則相當稀少。我們報告一位肺癌患者的杵狀指，在臨床肺癌對化學及放射治療有反應的同時，也看到杵狀指的改善。一位50歲的男子被診斷出非小細胞肺癌，他的初步症狀是咳嗽有痰持續約2個月。胸部X光顯示，大約有一個9公分的腫瘤在右上肺葉。經細針穿刺胸部的細胞學報告顯示為腺癌。臨床分期為T4N0M0，同時伴隨有縱隔腔的侵襲。杵狀指也同樣明顯。這位患者接受六次的化學治療平均每三週施打一次，紫杉醇180mg/平方公尺和順鉑75 mg/平方公尺，以及放射治療52 Gy。腫瘤治療後顯著縮小。杵狀指同時也改善。病人治療後已追蹤12個月並無復發。
並列摘要
Digital clubbing is a clinically sign that typically indicates pulmonary or cardiac disease. It is not uncommon and can occur in all cell types of lung cancer [1]. The exact mechanism for clubbing is still not fully understood. A reversal of clubbing after resection of the lung cancer has been reported in several publications [2], but improvement in digital clubbing after chemotherapy or radiotherapy is seldom reported. We herein report a lung cancer patient whose clubbing fingers improved simultaneously with the clinical response after chemotherapy and radiotherapy. A 50-year-old man was diagnosed with non-small cell lung cancer and the initial presentation was productive cough for 2 months. Chest radiography showed a mass 9 cm at the right upper lobe. Cytology of the transthoracic needle aspiration revealed adenocarcinoma. The clinical stage was T4N0M0 with mediastinal invasion, using a CT scan. The clubbing fingers were also remarkable. He received 6 courses of chemotherapy with paclitaxel 180 mg/m^2 plus cisplatin 75 mg/m^2 every 3 weeks followed by radiotherapy 52 Gy. The tumor shrank significantly after treatment. The clubbing fingers also improved simultaneously. The patient was followed up for 12 months after treatment without recurrence.
延伸閱讀
- 張明志（2007）。化療可以控制緩解但無法根治的癌症（八）非小細胞肺癌。健康世界，(260)，41-49。https://doi.org/10.6454/HW.200708.0041
- 柯獻欽、鄭高珍（2018）。晚期非小細胞肺癌之化學治療與標靶治療。內科學誌，29(3)，143-152。https://doi.org/10.6314/JIMT.201806_29(3).04
- Hsueh, F. J., Huang, H. C., & Hong, R. L. (2015). 局部晚期無法開刀之腺樣囊狀癌經動脈化療後腫瘤明顯縮小. 台灣癌症醫學雜誌, 2(2), 151-156. https://doi.org/10.6323/JCRP.2015.2.2.06
- Tsai, S. H., & Chang, H. Y. (2010). 肺原始性神經外胚層腫瘤併杵狀指－個案報告. 胸腔醫學, 25(4), 190-196. https://doi.org/10.29806/TM.201008.0004
- 張明志（2006）。化療可以控制緩解但無法根治的癌症（二）－小細胞癌、鼻咽癌。健康世界，(245)，21-25。https://doi.org/10.6454/HW.200605.0021