化学放射線療法が奏効した食道癌肉腫の1例

抄録

Carcinosarcoma of the esophagus is a relatively rare malignant neoplasm. Esophagectomy with regional lymph node dissection has often been performed to cure patients with this condition. Chemoradiotherapy has also been used to treat unresectable carcinosarcoma. This report describes an 83-year-old man with carcinosarcoma of the esophagus who was treated with chemoradiotherapy. Barium swallow examination showed an elevated lesion─measuring about 80 mm in diameter─in the thoracic and abdominal esophagus. Endoscopic examination revealed a type 2 tumor ＋IIb lesion in the esophagus. Histological analysis of a biopsy from the tumor demonstrated a carcinosarcoma. CT scan showed no evidence of lymph node swelling or distant metastasis. Thus, the clinical diagnosis was T3N0M0 cStage II. The patient declined surgery. Chemoradiotherapy─consisting of 5-FU and CDDP with radiotherapy of 60 Gy─was administered to the patient. He did not undergo additional chemotherapy, as he and his family wished to cease therapy. Endoscopic examination revealed that the carcinosarcoma had decreased in size.
The patient has now been alive for 15 months since initiation of treatment.