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━━ Background. Small cell lung cancer is highly sensitive to chemotherapy and radiation therapy. Standard therapies have been established for first line treatment. However, most cases develop relapse. To improve the prognosis, not only first line standard therapy but also second line standard therapy is very important. Case. A 74year-old man was treated with 4 cycles of CDDP and CPT-11 therapy. Thereafter, he showed complete response(CR) and remained in remission till December 2005. During the middle of December 2005, he developed severe pain in the left femoral neck. Multiple bone metastases were detected by bone scintigram. He was considered to be in a sensitive relapse state because 12 months had passed since the last chemotherapy. However his Eastern Cooperative Oncology Group performance status(PS)at that time was 3 due to renal insufficiency as well as difficulty in eating and walking by himself. Considering these factors, we selected amrubicin monotherapy as second line therapy. After administration of amrubicin, the severity of pain quickly regressed. Bone scintigram after 4 cycles of amrubicin therapy demonstrated remarkable improvement of the multiple bone metastases. Furthermore maintaining CR for about 15 months following amrubicin therapy was observed. Conclusion. There have been some reports of a phase II trial showing the 1星ヶ丘厚生年金病院呼吸器内科;奈良県立医科大学 2放射線 科,3第二内科. 別刷請求先:中村孝人,星ヶ丘厚生年金病院呼吸器科,〒5738511 大阪府枚方市星丘 4丁目 8番 1号. 1Department of Respiratory Medicine, Hoshigaoka Koseinenkin Hospital, Japan; 2Department of Radiology, 3Department of Respiratory Medicine, Nara Medical University, Japan. Reprints: Takahito Nakamura, Department of Respiratory Medicine, Hoshigaoka Koseinenkin Hospital, 4-8-1 Hoshigaoka, Hirakatashi, Osaka 573-8511, Japan. Received June 4, 2007; accepted August 9, 2007. 2007 The Japan Lung Cancer Society Japanese Journal of Lung Cancer―Vol 47, No 6, Oct 20, 2007―www.haigan.gr.jp 729 Table 1. Laboratory Findings on Admission Blood chemistry Hematology g/dl 7.6 TP /μl 388×104 RBC g/dl 3.5 ALB g/dl 13.4 Hb ↑ IU/l 1389 ALP % 39.6 Ht IU/l 37 GOT /μl 13900 WBC IU/l 37 GPT % 65 Neu IU/l 196 LDH % 3.8 Eo IU/l 22.8 BUN % 0.5 Ba ↑ mg/dl 1.4 Cr % 23.5 Ly mg/dl 145 Na % 6.9 Mo mEq/l 3.9 K /μl 25.2×104 Plt ↑ mg/dl 0.88 CRP はじめに 再発時の小細胞肺癌に対するセカンドラインの治療 は,現在トポテカン投与が標準治療とされているが,そ の奏効率は 16.3%で,再発形式別にみても sensitive ケースで 20.2%,refractory ケースで 4.0%であり,満足 のいくものではない.1 従って小細胞肺癌の予後向上の ためには初回治療のみならず,再発例に対する治療効果 の改善が求められている.そのような背景のもと,再発 性小細胞肺癌に対する塩酸アムルビシンの有効性が報告 されている.2 今回多発性骨転移で再発した小細胞肺癌 に対して塩酸アムルビシン投与を行い,転移病巣の消失 を認め,かつ長期の効果持続期間を得た症例を経験した ので報告する.

A Case of Relapsed Small Cell Lung Cancer with Remarkable Regression of Multiple Bone Metastases by Amrubicin Therapy