内容紹介
Summary
We report a case of recurrent sigmoid cancer in which long-term disease control was achieved by intermittent oxaliplatin(L-OHP)administration. A 58-year-old woman underwent first-line chemotherapy with capecitabine and L-OHP(CapeOX)following peritoneal lymph node recurrence of sigmoid cancer. Tumor shrinkage was confirmed by a computed tomography(CT)scan following 4 courses of CapeOX treatment. However, L-OHP administration was discontinued by the 9 course due to peritoneal neuropathy. L-OHP was reintroduced following tumor progression confirmed by CT or elevation of carcinoembryonic antigen levels detected by a blood test. This stop-and-go strategy controlled lymph node recurrence effectively for over 5 years and was not associated with the development of peritoneal neuropathy. We suggest that the intermittent administration of L-OHP-containing chemotherapy is an important treatment option for some patients with advanced colorectal cancer, achieving effective long-term disease control with no associated peripheral neuropathy.
要旨
症例は58歳,女性。S状結腸癌術後腹腔内再発に対し,CapeOXによる治療を開始した。治療開始後CEA減少およびCTにて再発病変の縮小を認めたが,末梢神経障害の増悪を認めたためcapecitabine単剤治療に変更した。病変増大所見や末梢神経障害の状況によってoxaliplatin(L-OHP)の間欠投与を繰り返し,約5年間QOLを維持した状態で病勢制御が可能であった。L-OHPを含む治療を有効かつ末梢神経障害の増悪なく,長期間継続するには本症例のようにL-OHPの間欠投与を繰り返すことが重要と考えられた。
目次
We report a case of recurrent sigmoid cancer in which long-term disease control was achieved by intermittent oxaliplatin(L-OHP)administration. A 58-year-old woman underwent first-line chemotherapy with capecitabine and L-OHP(CapeOX)following peritoneal lymph node recurrence of sigmoid cancer. Tumor shrinkage was confirmed by a computed tomography(CT)scan following 4 courses of CapeOX treatment. However, L-OHP administration was discontinued by the 9 course due to peritoneal neuropathy. L-OHP was reintroduced following tumor progression confirmed by CT or elevation of carcinoembryonic antigen levels detected by a blood test. This stop-and-go strategy controlled lymph node recurrence effectively for over 5 years and was not associated with the development of peritoneal neuropathy. We suggest that the intermittent administration of L-OHP-containing chemotherapy is an important treatment option for some patients with advanced colorectal cancer, achieving effective long-term disease control with no associated peripheral neuropathy.
要旨
症例は58歳,女性。S状結腸癌術後腹腔内再発に対し,CapeOXによる治療を開始した。治療開始後CEA減少およびCTにて再発病変の縮小を認めたが,末梢神経障害の増悪を認めたためcapecitabine単剤治療に変更した。病変増大所見や末梢神経障害の状況によってoxaliplatin(L-OHP)の間欠投与を繰り返し,約5年間QOLを維持した状態で病勢制御が可能であった。L-OHPを含む治療を有効かつ末梢神経障害の増悪なく,長期間継続するには本症例のようにL-OHPの間欠投与を繰り返すことが重要と考えられた。