内容紹介
Summary
In order to reduce the frequency and the severity of oxaliplatin-related sensory-neuropathy and preserve antitumor efficacy, we performed alternating 4 mFOLFOX6 and 4 FOLFIRI cycles, in combination with bevacizumab, in patients with metastatic colorectal cancer. The response rate of alternating mFOLFOX6 and FOLFIRI regimens(FIREFOX)plus bevacizumab was 100%. However, during neoadjuvant chemotherapy for colon cancer, we cannot use bevacizumab due to the concern of adverse events, such as bleeding and perforation. Therefore, we used cetuximab in 8 courses of FIREFOX. As a result, the volumes of the rectum cancers and liver metastases decreased. Thereafter, we used bevacizumab in another 8 courses of FIREFOX. A 77-year-old woman suffered from Ⅱ type rectum cancer, which was localized 7 cm from the anal verge, with multiple liver metastases. We performed 8 courses of FIREFOX plus cetuximab. After observing a decrease in tumor burden, we performed another 8 courses FIREFOX plus bevacizumab. As a result, CEA and CA19-9 decreased to the normal range, and the size of the rectum cancer and liver metastases decreased. She underwent laparoscopic lower anterior and liver resections in the high-volume center. She presently remains alive with no sighs of recurrence, 18 months after resection.
要旨
当院ではmFOLFOX6とFOLFIRIをそれぞれの有害事象を減らすため,4回ずつ交互に行う交代療法(FIREFOX)にbevacizumabを加えた化学療法を施行し,切除不能大腸癌に対して100%の奏効率を示してきた。しかしながら,術前化学療法になると原発巣からの出血や穿孔が懸念され,bevacizumabは使用しにくい。そこで,最初の8コースはcetuximabを用い,次の8コースでbevacizumabを使用し手術可能となった1例を経験した。症例は77歳,女性。肛門縁から約7 cmの下部直腸にⅡ型腫瘍と多発性肝転移を認めた。FIREFOX+cetuximabを8コース施行した。腫瘍の縮小を待って,FIREFOX+bevacizumabを8コース施行した。腫瘍マーカーは正常値化し,基幹病院に紹介し肝切除と低位前方切除術を施行,現在,無再発で生存中である。
目次
In order to reduce the frequency and the severity of oxaliplatin-related sensory-neuropathy and preserve antitumor efficacy, we performed alternating 4 mFOLFOX6 and 4 FOLFIRI cycles, in combination with bevacizumab, in patients with metastatic colorectal cancer. The response rate of alternating mFOLFOX6 and FOLFIRI regimens(FIREFOX)plus bevacizumab was 100%. However, during neoadjuvant chemotherapy for colon cancer, we cannot use bevacizumab due to the concern of adverse events, such as bleeding and perforation. Therefore, we used cetuximab in 8 courses of FIREFOX. As a result, the volumes of the rectum cancers and liver metastases decreased. Thereafter, we used bevacizumab in another 8 courses of FIREFOX. A 77-year-old woman suffered from Ⅱ type rectum cancer, which was localized 7 cm from the anal verge, with multiple liver metastases. We performed 8 courses of FIREFOX plus cetuximab. After observing a decrease in tumor burden, we performed another 8 courses FIREFOX plus bevacizumab. As a result, CEA and CA19-9 decreased to the normal range, and the size of the rectum cancer and liver metastases decreased. She underwent laparoscopic lower anterior and liver resections in the high-volume center. She presently remains alive with no sighs of recurrence, 18 months after resection.
要旨
当院ではmFOLFOX6とFOLFIRIをそれぞれの有害事象を減らすため,4回ずつ交互に行う交代療法(FIREFOX)にbevacizumabを加えた化学療法を施行し,切除不能大腸癌に対して100%の奏効率を示してきた。しかしながら,術前化学療法になると原発巣からの出血や穿孔が懸念され,bevacizumabは使用しにくい。そこで,最初の8コースはcetuximabを用い,次の8コースでbevacizumabを使用し手術可能となった1例を経験した。症例は77歳,女性。肛門縁から約7 cmの下部直腸にⅡ型腫瘍と多発性肝転移を認めた。FIREFOX+cetuximabを8コース施行した。腫瘍の縮小を待って,FIREFOX+bevacizumabを8コース施行した。腫瘍マーカーは正常値化し,基幹病院に紹介し肝切除と低位前方切除術を施行,現在,無再発で生存中である。