パクリタキセル＋カルボプラチン併用化学療法でpartial responseが得られた原発不明癌多発骨転移の1例

Multiple Bone Metastases by an Unknown Primary Carcinoma Successfully Treated with Paclitaxel and Carboplatin Combination Chemotherapy. Case Report

　症例は75歳の女性で，左上腕骨病的骨折で発症した原発不明癌骨転移で，胸骨，大腿骨，肩甲骨にも骨転移を認めた．左上腕骨に36Gyの放射線照射を行い，続いてパクリタキセル(PTX)175mg/m²とカルボプラチン(CBDCA)AUC 6の併用化学療法を開始した．4週に1回，10コース行ったところ，上腕骨病的骨折部に骨形成がみられ，遷延癒合となった．他の転移巣も縮小が認められた．原発不明癌骨転移に対するPTXとCBDCAの併用化学療法は，有害事象も少なく，耐用可能であり有効な治療法の選択枝となり得る．

　The patient was a 75-year-old female with a pathological fracture of the left humerus who was referred to our hospital.　The pathological diagnosis based on an open biopsy of the humerus was adenocarcinoma, but standard diagnostic investigations yielded no evidence of the site of origin.　Multiple bone metastases were detected by bone scintigraphy, and a diagnosis of multiple bone metastasis by an unknown primary adenocarcinoma was made.　We treated the patient by radiotherapy of the left humerus to a total dose of 36 Gy followed by paclitaxel (175mg/m²) plus carboplatin (AUC 6) combination chemotherapy.　PTX and CBDCA were administered on day 1 every 4weeks for 10 cycles.　The only adverse effect was grade 2 neutropenia.　New bone formation occurred in the left humerus, and reduction of the size of the other bone metastases was observed.　The results indicated that PTX plus CBDCA combination chemotherapy is safe and effective for the treatment of bone metastasis by an unknown primary carcinoma.