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開催概要
開催回
第58回・2020年・京都
 

ゲムシタビン単剤療法が病勢制御に寄与した進行期右房原発心臓血管肉腫の一例

演題番号 : P-412

[筆頭演者]
今井 亨:1 
[共同演者]
吉田 幸生:1、島袋 将志:1、高橋 孝典:2、和氣 稔:2、朝倉 義崇:1

1:沖縄県立中部病院・腫瘍・血液内科、2:沖縄県立中部病院・循環器内科

 

<Background>
Primary cardiac sarcomas are rare tumors, with the most common histologic type being angiosarcoma. Although paclitaxel is recommended for treatment of angiosarcoma, primary cardiac angiosarcomas are not well documented in the literature. Primary cardiac sarcoma has a poor prognosis, with an average survival of about 1 year. We report here a patient who has survived more than 2 years receiving gemcitabine alone as 5th line chemotherapy.
<Case>
A 67-year old woman with a mass in the right atrium was diagnosed with angiosarcoma by transcatheter biopsy. Multiple lung metastases and metastasis in the left supraclavicular fossa lymph node were found in PET-CT imaging.
Systemic therapy was initiated using paclitaxel (70 mg/m2 on day 1,8,15, every 4 weeks) as 1st line treatment. After the 2nd cycles of administration, ground glass opacities were observed on both lungs, and treatment was discontinued due to drug-induced interstitial pneumonitis. Adriamycin (60 mg/m2 every 3 weeks) was subsequently administered for 6 cycles until cardiac dysfunction was detected. Afterwards, pazopanib was administered with dose reduction to 600 mg/day. However, she was judged intolerant due to severe gastrointestinal toxicity only 1 week after initiation. Although eribulin was started as the 4th line of chemotherapy, she experienced rapid disease progression with worsening symptoms of heart failure. Thereafter, administration of gemcitabine monotherapy (1000 mg/m2 on day 1, 8, 15, every 4 weeks) was begun. Due to hematologic toxicity, especially cytopenia, the administration schedule was changed to every other week. She achieved partial response after three cycles of treatment. Over a total of 16 cycles, disease progression was clinically interrupted and 2 years have passed since the diagnosis. Gemcitabine monotherapy is still ongoing.
<Conclusion>
This case suggests that gemcitabine monotherapy may improve survival and may be an effective option for primary cardiac angiosarcoma.

キーワード

臓器別:骨軟部

手法別:化学療法

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