학술논문

2回の気管支ステント挿入とphotodynamic therapyを含む集学的治療により全身状態の低下を伴わずに9th-lineまでの化学療法を継続しえた肺扁平上皮癌の1例 / Multidisciplinary Therapy Including Insertion of Two Stents, Photodynamic Therapy, and Nine-line Chemotherapy Against Lung Squamous Cell Carcinoma
Document Type
Journal Article
Source
気管支学 / The Journal of the Japan Society for Respiratory Endoscopy. 2021, 43(5):473
Subject
Central airway constriction
Lung cancer
Photodynamic therapy
Tracheobronchial stent
中枢気道狭窄
光線力学療法
気管支ステント
肺癌
Language
Japanese
ISSN
0287-2137
2186-0149
Abstract
Case. A 62-year-old man with lung squamous cell carcinoma (cT2bN3M0, cStage IIIB according to the 8th edition of Union for International Cancer Control) received carboplatin+nab-paclitaxel treatment in combination with radiation therapy (30 Gy) to improve airway constriction; however, pleural dissemination emerged. The chemotherapy regimen was switched several times based on tumor progression, and he received eighth-line S-1 treatment four years after the initial diagnosis, by which point the enlargement of the primary tumor had resulted in right main bronchial obstruction. Therefore, endobronchial tumor debulking was performed, and an uncovered stent was inserted into the right superior lobar bronchus through the right main bronchus. However, chest computed tomography and bronchoscopy performed one month later revealed in-stent tumor infiltration. The uncovered stent was replaced with a covered stent, and photodynamic therapy (PDT) was initiated for the tumor mass surrounding the right main bronchus. He received nineth-line vinorelbine treatment with a good performance status. Conclusion. Endobronchial interventions, such as tracheobronchial stents, and PDT play a pivotal role in the treatment of lung cancer with central airway constriction, helping to preserve the performance status of patients who can be treated with effective chemotherapy regimens.