内容紹介
A Case of Effective Chemoradiotherapy Using mFOLFOX6 for Locally Advanced Rectal Cancer
Summary
We report a case of locally advanced rectal cancer, treated effectively with chemotherapy consisting of mFOLFOX6 combined with radiotherapy. A 63-year-old man was admitted to our hospital in March 2012 for diarrhea and anal and perineal pain. Advanced rectal cancer with invasion of the right perineum was diagnosed based on computer tomography(CT)findings. Surgery was performed; however, the rectal cancer was unresectable. A sigmoid colostomy was performed, and a central venous port was implanted. In April 2012, the patient was treated with chemotherapy using 3 courses of mFOLFOX6 and concurrent radiotherapy. Radiotherapy at 2 Gy/day was administered 25 times(total dose, 50 Gy). After chemoradiotherapy, the patient underwent 3 courses of mFOLFOX6 as an additional therapy. By June 2012, CT showed resolution of the tumor in the right perineum and a marked decrease in the size of the primary rectal cancer. Because the patient refused surgery, we started treatment with combination chemotherapy using oral S-1 and intravenous CPT-11 in August 2012. After 18 courses, the treatment was changed to oral administration of S-1 alone, which was continued for 1 year. The patient remained well without recurrence for 54 months since the original diagnosis. Therefore, chemoradiotherapy with mFOLFOX6 is a possible option for the management of advanced rectal cancer.
要旨
症例は63歳,男性。2012年3月肛門周囲痛と下痢を主訴に受診した。CTで右会陰部に伸展する進行直腸癌と診断した。手術を施行したが根治術困難と考え,S状結腸人工肛門造設術を施行した。4月よりmFOLFOX6を用いた化学放射線療法(chemoradiotherapy: CRT)を開始した。mFOLFOX6は3コースおよび放射線治療は総線量50 Gyを施行した。CRT後にmFOLFOX6を3コース追加した。7月のCTでは右会陰部の腫瘍は消失し,直腸粘膜肥厚も軽減していた。手術希望がないため追加治療としてS-1+CPT-11療法を18コース,さらにS-1単独に変更して12コース施行した。2015年3月より抗癌剤治療は中止したまま経過観察しているが,診断後54か月経過し再発なく生存している。mFOLFOX6を用いたCRTは,進行直腸癌の治療として有効な治療法であると考えられた。
目次
Summary
We report a case of locally advanced rectal cancer, treated effectively with chemotherapy consisting of mFOLFOX6 combined with radiotherapy. A 63-year-old man was admitted to our hospital in March 2012 for diarrhea and anal and perineal pain. Advanced rectal cancer with invasion of the right perineum was diagnosed based on computer tomography(CT)findings. Surgery was performed; however, the rectal cancer was unresectable. A sigmoid colostomy was performed, and a central venous port was implanted. In April 2012, the patient was treated with chemotherapy using 3 courses of mFOLFOX6 and concurrent radiotherapy. Radiotherapy at 2 Gy/day was administered 25 times(total dose, 50 Gy). After chemoradiotherapy, the patient underwent 3 courses of mFOLFOX6 as an additional therapy. By June 2012, CT showed resolution of the tumor in the right perineum and a marked decrease in the size of the primary rectal cancer. Because the patient refused surgery, we started treatment with combination chemotherapy using oral S-1 and intravenous CPT-11 in August 2012. After 18 courses, the treatment was changed to oral administration of S-1 alone, which was continued for 1 year. The patient remained well without recurrence for 54 months since the original diagnosis. Therefore, chemoradiotherapy with mFOLFOX6 is a possible option for the management of advanced rectal cancer.
要旨
症例は63歳,男性。2012年3月肛門周囲痛と下痢を主訴に受診した。CTで右会陰部に伸展する進行直腸癌と診断した。手術を施行したが根治術困難と考え,S状結腸人工肛門造設術を施行した。4月よりmFOLFOX6を用いた化学放射線療法(chemoradiotherapy: CRT)を開始した。mFOLFOX6は3コースおよび放射線治療は総線量50 Gyを施行した。CRT後にmFOLFOX6を3コース追加した。7月のCTでは右会陰部の腫瘍は消失し,直腸粘膜肥厚も軽減していた。手術希望がないため追加治療としてS-1+CPT-11療法を18コース,さらにS-1単独に変更して12コース施行した。2015年3月より抗癌剤治療は中止したまま経過観察しているが,診断後54か月経過し再発なく生存している。mFOLFOX6を用いたCRTは,進行直腸癌の治療として有効な治療法であると考えられた。