内容紹介
Summary
Introduction: There are few reports on the outcome of relapsed cases after curative resection for colorectal cancer(CRC)with adjuvant oxaliplatin-based chemotherapy. Thus, we analyzed such cases. Patients and method: In total, 48 patients with CRC who received oxaliplatin-based postoperative adjuvant chemotherapy from 2012 were analyzed. The clinical course was examined in 9 cases of recurrence. Results: StagesⅡ, Ⅲa, and Ⅲb(1, 3, and 5 cases, respectively)were judged as recurrence in 9 cases. Metastatic sites were the lungs, local sites, liver, and peritoneum(3, 3, 3, and 1 case[s], respectively). The median time to relapse was 390 days. There were 2 cases of wild-type RAS and 7 cases of mutant RAS. Although R0 resection was performed in 1 case, re-relapse was recognized. Another 8 cases involved induced chemotherapy. An oxaliplatin-based regimen was administered as first-line treatment in 4 of 8 cases. At present, 5 patients died, and 3 of 8 cases could not progress to second-line treatment. The overall survival(OS)after relapse was 475 days, and survival more than 3 years was not observed. Conclusion: Recurrent cases after Cur A resection for CRC with oxaliplatin-based adjuvant chemotherapy were examined. Although the 3-year RFS and 5-year OS were relatively good, the prognosis after relapse was quite poor.
要旨
はじめに: オキサリプラチン併用補助化学療法後の再発例の治療成績に関する報告は少ない。そこで,治癒切除後のオキサリプラチン併用補助化学療法施行後の再発例について検討した。対象・方法: 対象は2012年以降に術後補助化学療法にオキサリプラチンを併用した大腸癌症例48例のうち再発を認めた9例で臨床経過につき検討した。結果: 再発9例のStage(Ⅱ/Ⅲa/Ⅲb)は各1/3/5例で,再発臓器は肺3例,局所3例,肝臓3例,腹膜が1例,再発までの期間の中央値は390日,RAS遺伝子は野生型2例,変異型が7例であった。再発治療は転移巣手術1例,化学療法が8例で,手術例は再再発した。化学療法8例中4例の一次治療にオキサリプラチンが使用された。現時点で5例死亡,8例中3例は一次治療のみであった。再発後の生存期間中央値は475日,現時点で3年生存例を認めていない。結語: 根治度A大腸癌術後オキサリプラチン併用補助化学療法後の再発例について検討した。3年無再発生存率や5年生存率は比較的良好であったが,再発例の予後は不良であった。
目次
Introduction: There are few reports on the outcome of relapsed cases after curative resection for colorectal cancer(CRC)with adjuvant oxaliplatin-based chemotherapy. Thus, we analyzed such cases. Patients and method: In total, 48 patients with CRC who received oxaliplatin-based postoperative adjuvant chemotherapy from 2012 were analyzed. The clinical course was examined in 9 cases of recurrence. Results: StagesⅡ, Ⅲa, and Ⅲb(1, 3, and 5 cases, respectively)were judged as recurrence in 9 cases. Metastatic sites were the lungs, local sites, liver, and peritoneum(3, 3, 3, and 1 case[s], respectively). The median time to relapse was 390 days. There were 2 cases of wild-type RAS and 7 cases of mutant RAS. Although R0 resection was performed in 1 case, re-relapse was recognized. Another 8 cases involved induced chemotherapy. An oxaliplatin-based regimen was administered as first-line treatment in 4 of 8 cases. At present, 5 patients died, and 3 of 8 cases could not progress to second-line treatment. The overall survival(OS)after relapse was 475 days, and survival more than 3 years was not observed. Conclusion: Recurrent cases after Cur A resection for CRC with oxaliplatin-based adjuvant chemotherapy were examined. Although the 3-year RFS and 5-year OS were relatively good, the prognosis after relapse was quite poor.
要旨
はじめに: オキサリプラチン併用補助化学療法後の再発例の治療成績に関する報告は少ない。そこで,治癒切除後のオキサリプラチン併用補助化学療法施行後の再発例について検討した。対象・方法: 対象は2012年以降に術後補助化学療法にオキサリプラチンを併用した大腸癌症例48例のうち再発を認めた9例で臨床経過につき検討した。結果: 再発9例のStage(Ⅱ/Ⅲa/Ⅲb)は各1/3/5例で,再発臓器は肺3例,局所3例,肝臓3例,腹膜が1例,再発までの期間の中央値は390日,RAS遺伝子は野生型2例,変異型が7例であった。再発治療は転移巣手術1例,化学療法が8例で,手術例は再再発した。化学療法8例中4例の一次治療にオキサリプラチンが使用された。現時点で5例死亡,8例中3例は一次治療のみであった。再発後の生存期間中央値は475日,現時点で3年生存例を認めていない。結語: 根治度A大腸癌術後オキサリプラチン併用補助化学療法後の再発例について検討した。3年無再発生存率や5年生存率は比較的良好であったが,再発例の予後は不良であった。