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題 名 | 大腸直腸癌合併肺癌之藥物治療=Pharmacotherapy of Synchronous Cancer of Colon and Lung |
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作 者 | 陳弘益; 林文亮; 葉鳳英; 張慧真; | 書刊名 | 藥學雜誌 |
卷 期 | 32:2=127 2016.06[民105.06] |
頁 次 | 頁84-88 |
分類號 | 418.31 |
關鍵詞 | 雙重癌症; 大腸癌; 肺癌; 藥物治療; |
語 文 | 中文(Chinese) |
中文摘要 | 雖然癌症發生率逐年增加,多重癌症的病人仍屬罕見。在此我們報導一位64歲的男 性,因肛門流血六個月求診而診斷為直腸乙狀結腸接合點癌,同時電腦斷層發現右上肺 部結節,侵犯氣管旁縱膈腔淋巴結,疑似惡性腫瘤,病人有第二型糖尿病、攝護腺肥 大和腎結石病史,胸腔內視鏡輔助手術切片結果顯示 thyroid transcription factor-1 (TTF- 1) 陽性、cytokeratin 7 (CK7) 陽性和 cytokeratin 20 (CK20) 陰性。診斷為第三期直腸乙狀 結腸接合點癌合併第四期肺癌,KRAS 基因檢測結果為野生型,EGFR 基因檢測結果為 L858R 突變型。在結腸低前位切除術後,病人接受 FOLFOX 加上口服 erlotinib 治療。 由於缺乏多重癌症的治療準則,未來還需要更多多重癌症的治療研究報告。 |
英文摘要 | Despite cancer rates are increasing, multiple primary malignancies remain rare. Here we present a 64-year-old male with anal bleeding for 6 months and was diagnosed as rectosigmoid colon cancer. He also had type II diabetes mellitus, benign prostate hyperplasia and renal calculus. At the same time computed tomography revealed right upper lung nodule involving right paratracheal space with mediastinal lymph nodes. He was finally diagnosed with synchronous cancer of colon and lung. Video-assisted thoracoscopic lung biopsy demonstrated thyroid transcription factor-1(TTF-1) positive, cytokeratin 7(CK7) positive and cytokeratin 20(CK20) negative. Diagnosis of stage III recto-sigmoid colon cancer with stage IV lung cancer was made. Rectosigmoid colon cancer KRAS gene mutation testing revealed wild type, and lung cancer EGFR genetic testing revealed EGFR L858R mutation. After laparoscopic low anterior resection, our patient received FOLFOX plus erlotinib. The lack of treatment guidelines and published research often leave oncologists with no clear way to treat patients who present with synchronous cancers. Further researches about therapeutic protocols on multiple primary malignancies are warranted. |
本系統中英文摘要資訊取自各篇刊載內容。