Second-line chemotherapy for refractory small cell neuroendocrine carcinoma of the esophagus that relapsed after complete remission with irinotecan plus cisplatin therapy: Case report and review of the literature

  • Authors:
    • Shinsuke Funakoshi
    • Akinori Hashiguchi
    • Kana Teramoto
    • Naoteru Miyata
    • Satoshi Kurita
    • Masayuki Adachi
    • Yasuo Hamamoto
    • Hajime  Higuchi
    • Hiromasa Takaishi
    • Toshifumi Hibi
  • View Affiliations

  • Published online on: October 30, 2012     https://doi.org/10.3892/ol.2012.1008
  • Pages: 117-122
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Abstract

Small cell esophageal carcinoma is a type of small cell neuroendocrine carcinoma (SCNEC). SCNEC follows an aggressive clinical course and has a poor prognosis despite multidisciplinary therapies. A standard therapeutic strategy, including surgery, radiation and first-/second‑line chemotherapy, has not yet been established for SCNEC. We present a case of SCNEC of the esophagus. A 66-year-old male with SCNEC as extensive disease was treated with 60 mg/m2 cisplatin on day 1 plus 60 mg/m2 irinotecan on days 1, 8 and 15 every 4 weeks (IP) with successful complete remission. After the sixth course of IP, increasing pro-gastrin-releasing peptide (ProGRP) and nonspecific enolase (NSE) levels and intense fluorodeoxyglucose (FDG) avidity in a lymph node around the celiac artery (SUVmax, 8.3) indicated a refractory relapse of the disease. The patient was treated with three courses of amrubicin (AMR, 35 mg/m2) administered intravenously for 3 consecutive days every 3 weeks as a second‑line chemotherapy. The ProGRP and NSE levels returned to the normal range 1 month after the initiation of second-line chemotherapy. However, the ProGRP and NSE levels were elevated after the third course of AMR, and PET-CT revealed progressive disease with liver metastasis and extended lymph node metastasis. As the patient remained asymptomatic, paclitaxel (100 mg/m2) was started as third-line chemotherapy. Patients with SCNEC of the esophagus with extensive disease should be treated with aggressive chemotherapy rather than surgery or radiation monotherapy. In the present case, tumor markers such as ProGRP and NSE were predictive of relapse and PET-CT was used to detect relapse. Further research is required to identify and exploit promising agents for resistant SCNEC.
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January 2013
Volume 5 Issue 1

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Funakoshi S, Hashiguchi A, Teramoto K, Miyata N, Kurita S, Adachi M, Hamamoto Y, Higuchi H, Takaishi H, Hibi T, Hibi T, et al: Second-line chemotherapy for refractory small cell neuroendocrine carcinoma of the esophagus that relapsed after complete remission with irinotecan plus cisplatin therapy: Case report and review of the literature. Oncol Lett 5: 117-122, 2013
APA
Funakoshi, S., Hashiguchi, A., Teramoto, K., Miyata, N., Kurita, S., Adachi, M. ... Hibi, T. (2013). Second-line chemotherapy for refractory small cell neuroendocrine carcinoma of the esophagus that relapsed after complete remission with irinotecan plus cisplatin therapy: Case report and review of the literature. Oncology Letters, 5, 117-122. https://doi.org/10.3892/ol.2012.1008
MLA
Funakoshi, S., Hashiguchi, A., Teramoto, K., Miyata, N., Kurita, S., Adachi, M., Hamamoto, Y., Higuchi, H., Takaishi, H., Hibi, T."Second-line chemotherapy for refractory small cell neuroendocrine carcinoma of the esophagus that relapsed after complete remission with irinotecan plus cisplatin therapy: Case report and review of the literature". Oncology Letters 5.1 (2013): 117-122.
Chicago
Funakoshi, S., Hashiguchi, A., Teramoto, K., Miyata, N., Kurita, S., Adachi, M., Hamamoto, Y., Higuchi, H., Takaishi, H., Hibi, T."Second-line chemotherapy for refractory small cell neuroendocrine carcinoma of the esophagus that relapsed after complete remission with irinotecan plus cisplatin therapy: Case report and review of the literature". Oncology Letters 5, no. 1 (2013): 117-122. https://doi.org/10.3892/ol.2012.1008