緩和的な放射線照射が奏効した終末期前立腺癌の2例

Abstract

Herein we report two cases of palliative radiation therapy for retroperitoneal lymph node metastasis (RLNM) causing annoying leg edema in castration-resistant prostate cancer (CRPC) patients in the terminal phase. [Case 1] A 53-year-oldman with T3bN0M1a prostate cancer was treated with androgen deprivation therapy (ADT). After 9 months, he developed CRPC with local progression that required local radiation therapy (75.6 Gy/36 fr). Disease progression after life-prolonging therapies was followed only by best supportive care (BSC). Radiation therapy (40 Gy/20 fr) was performed for the RLNM due to which he suffered from painful leg edema. Although the painful leg edema was alleviated, he died of prostate cancer after 2 months. [Case 2] A 71-year-oldman with T4N1M1a prostate cancer was treated with ADT plus bicalutamide. After 10 months, he developed CRPC. He was treated with only BSC for disease progression after life-prolonging therapies. He had RLNM that caused painful leg edema, making it difficult for him to stretch and lie on his back. Radiation therapy (16 Gy/2 fr) was performed for the RLNM. His condition improved enough that he was able to move to a wheelchair and lie on his back. However, he died of prostate cancer without recurrence of the painful leg edema after one month. Our experience with these two CRPC patients with severe leg edema due to the RLNM indicates that radiation therapy for lymph node metastasis may be included as one of the treatment options even for terminal disease.