内容紹介
Summary
We reported 2 cases of colorectal cancer receiving neoadjuvant chemotherapy(NAC)with the aim of curative resection or anal preservation. Case 1: A 50-year-old man was diagnosed with locally advanced rectal cancer with sacral invasion. Because of the sacral invasion, we performed preoperative chemotherapy. He was treated with 12 courses of CapeOX plus Bmab and 3 courses of capecitabine plus radiation therapy(45 Gy in total). After chemoradiation therapy, a lower anterior resection was performed. The pathological finding was pT3pN0pM0, pStageⅡ. Case 2: A 69-year-old man was diagnosed with lower rectal cancer. Colonoscopy revealed a tumor near the dentate line. Because the patient desired anal preservation, we performed preoperative chemotherapy. He was treated with IRIS plus Bmab. After 3 courses of chemotherapy, the tumor had reduced in size. The pathological findings were no residual tumor cell, pN0. In our hospital, we have preserved the anus in 2 patients after NAC. Including the above 2 cases, we have performed curative resection in 7 cases. The mean observation period after surgery was 30 months; 1 case died from cancer recurrence(41 months after resection)and other 6 cases lived without cancer relapse.
要旨
当院で腫瘍縮小による肛門温存や治癒切除を目的に術前化学療法(neoadjuvant chemotherapy: NAC)を行い,良好な結果が得られた症例を報告する。症例1: 50歳,男性。切除不能直腸癌に対しCapeOX+Bmab 12コース,capecitabine 3コース+放射線治療(計45 Gy)を施行し,低位前方切除術を施行した。病理所見はpT3pN0pM0,pStageⅡであり,効果判定基準はGrade 1a～1bであった。症例2: 69歳,男性。直腸癌に対し肛門温存を目的とし,NACとしてIRIS+Bmab 3コース施行後,ISR+横行結腸人工肛門造設術を施行した。病理所見ではno residual tumor cell,pN0で,効果判定基準はGrade 3であった。当院では上記2例を含め,NACを施行した大腸癌7症例中2例で肛門の温存ができ,切除不能局所進行大腸癌5例で治癒切除可能となった。術後の平均観察期間は30か月で,死亡は1例(術後41か月原病死),6例は無再発生存であった。
目次
We reported 2 cases of colorectal cancer receiving neoadjuvant chemotherapy(NAC)with the aim of curative resection or anal preservation. Case 1: A 50-year-old man was diagnosed with locally advanced rectal cancer with sacral invasion. Because of the sacral invasion, we performed preoperative chemotherapy. He was treated with 12 courses of CapeOX plus Bmab and 3 courses of capecitabine plus radiation therapy(45 Gy in total). After chemoradiation therapy, a lower anterior resection was performed. The pathological finding was pT3pN0pM0, pStageⅡ. Case 2: A 69-year-old man was diagnosed with lower rectal cancer. Colonoscopy revealed a tumor near the dentate line. Because the patient desired anal preservation, we performed preoperative chemotherapy. He was treated with IRIS plus Bmab. After 3 courses of chemotherapy, the tumor had reduced in size. The pathological findings were no residual tumor cell, pN0. In our hospital, we have preserved the anus in 2 patients after NAC. Including the above 2 cases, we have performed curative resection in 7 cases. The mean observation period after surgery was 30 months; 1 case died from cancer recurrence(41 months after resection)and other 6 cases lived without cancer relapse.
要旨
当院で腫瘍縮小による肛門温存や治癒切除を目的に術前化学療法(neoadjuvant chemotherapy: NAC)を行い,良好な結果が得られた症例を報告する。症例1: 50歳,男性。切除不能直腸癌に対しCapeOX+Bmab 12コース,capecitabine 3コース+放射線治療(計45 Gy)を施行し,低位前方切除術を施行した。病理所見はpT3pN0pM0,pStageⅡであり,効果判定基準はGrade 1a～1bであった。症例2: 69歳,男性。直腸癌に対し肛門温存を目的とし,NACとしてIRIS+Bmab 3コース施行後,ISR+横行結腸人工肛門造設術を施行した。病理所見ではno residual tumor cell,pN0で,効果判定基準はGrade 3であった。当院では上記2例を含め,NACを施行した大腸癌7症例中2例で肛門の温存ができ,切除不能局所進行大腸癌5例で治癒切除可能となった。術後の平均観察期間は30か月で,死亡は1例(術後41か月原病死),6例は無再発生存であった。