内容紹介
An Elderly Patient with Metastatic Colon Cancer Achieved Long-Term Survival Following Single-Agent Chemotherapy with S-1
Summary
Colorectal cancer is a common malignancy and a major health issue in geriatrics. Systemic chemotherapy should be considered for elderly patients. We report an 85-year-old man with metastatic cecal cancer who has achieved long-term survival following single-agent chemotherapy with S-1. His fecal occult blood test results were positive; he then underwent colonoscopy and was diagnosed with cecal cancer. Chest CT revealed multiple metastases in both lungs. Since radical excision was infeasible, we performed right hemicolectomy to prevent bowel obstruction. Histological examination revealed a T3, N0, M1a(PUL2), Stage Ⅳ tumor. After discharge from the hospital, the patient preferred receiving chemotherapy that would have fewer side effects. S-1 monotherapy was administered. Despite increased progression of the pulmonary metastases, he experienced no subjective symptoms, his QOL remained consistent, and he completed 42 cycles of chemotherapy in total. The patient is currently being managed on an outpatient basis. In conclusion, elderly patients with cancer should be carefully evaluated according to both disease control and individual circumstances, such as patient's tolerability, QOL, and preference.
要旨
高齢大腸癌患者は増加しており,高齢患者に全身化学療法を行う機会も多くなってきている。今回,根治切除不能な高齢者大腸癌に対し,原発巣切除後にS-1単剤療法を施行し長期生存を得ることができた症例を経験したので報告する。症例は85歳,男性。同時性両側多発肺転移を伴う大腸癌に対し結腸右半切除術を施行した。病期はT3,N0,M1a(PUL2),Stage Ⅳであった。副作用の少ない化学療法を希望したためS-1単剤による治療を開始した。QOLを維持したまま計42サイクル施行され,現在も外来通院中である。高齢癌患者の化学療法においては病勢コントロールだけにとらわれず,忍容性,QOL,患者の希望など個々の事情に配慮しながら治療を選択することが肝要であると考えられた。
目次
Summary
Colorectal cancer is a common malignancy and a major health issue in geriatrics. Systemic chemotherapy should be considered for elderly patients. We report an 85-year-old man with metastatic cecal cancer who has achieved long-term survival following single-agent chemotherapy with S-1. His fecal occult blood test results were positive; he then underwent colonoscopy and was diagnosed with cecal cancer. Chest CT revealed multiple metastases in both lungs. Since radical excision was infeasible, we performed right hemicolectomy to prevent bowel obstruction. Histological examination revealed a T3, N0, M1a(PUL2), Stage Ⅳ tumor. After discharge from the hospital, the patient preferred receiving chemotherapy that would have fewer side effects. S-1 monotherapy was administered. Despite increased progression of the pulmonary metastases, he experienced no subjective symptoms, his QOL remained consistent, and he completed 42 cycles of chemotherapy in total. The patient is currently being managed on an outpatient basis. In conclusion, elderly patients with cancer should be carefully evaluated according to both disease control and individual circumstances, such as patient's tolerability, QOL, and preference.
要旨
高齢大腸癌患者は増加しており,高齢患者に全身化学療法を行う機会も多くなってきている。今回,根治切除不能な高齢者大腸癌に対し,原発巣切除後にS-1単剤療法を施行し長期生存を得ることができた症例を経験したので報告する。症例は85歳,男性。同時性両側多発肺転移を伴う大腸癌に対し結腸右半切除術を施行した。病期はT3,N0,M1a(PUL2),Stage Ⅳであった。副作用の少ない化学療法を希望したためS-1単剤による治療を開始した。QOLを維持したまま計42サイクル施行され,現在も外来通院中である。高齢癌患者の化学療法においては病勢コントロールだけにとらわれず,忍容性,QOL,患者の希望など個々の事情に配慮しながら治療を選択することが肝要であると考えられた。