内容紹介
Summary
This case involved a 28-year-old female with rectal cancer in the inner pelvis. Two courses of SOX plus Cmab therapy, and 4 courses of FOLFOX-Cmab therapy were administered as preoperative chemotherapies, which resulted in a reduction in the major lesion. Subsequently, laparoscopic low anterior resection and dissection of the bilateral lymph nodes were performed. After the surgery, adjuvant chemotherapy with FOLFOX was administered. Afterwards, the patient developed severe anal pain and visited us for treatment. The severe anal pain continued even after FOLFOX treatment and increased with defecation. A side effect of oxaliplatin was suspected, and sLV5FU chemotherapy was administered. As a result, the anal pain disappeared. Thus, the pain was considered to be induced by oxaliplatin. While peripheral neuropathy is a widely known side effect of oxaliplatin, this case was considered to be unique because anal pain occurs very rarely with oxaliplatin treatment.
要旨
症例は28歳,女性。骨盤内を占拠する直腸癌を認め,術前化学療法としてSOX+Cmab療法を2コースとFOLFOX+Cmab療法を4コース行い,主病巣の縮小を認めた後に腹腔鏡下低位前方切除術,両側側方リンパ節郭清術を施行した。術後にFOLFOXによる補助化学療法を実施したところ,激しい肛門部痛を訴え来院した。その後のFOLFOX治療後にも激しい肛門部痛を認め,排便により痛みは増強した。オキサリプラチンによる副作用を疑いsLV5FUによる補助化学療法を実施したところ肛門部痛の出現はいっさい認めず,オキサリプラチンに誘導された肛門部痛と断定した。オキサリプラチンによる末梢神経障害は広く知られた副作用であるが,肛門部痛を呈することは非常にまれで貴重な症例と考えられた。
目次
This case involved a 28-year-old female with rectal cancer in the inner pelvis. Two courses of SOX plus Cmab therapy, and 4 courses of FOLFOX-Cmab therapy were administered as preoperative chemotherapies, which resulted in a reduction in the major lesion. Subsequently, laparoscopic low anterior resection and dissection of the bilateral lymph nodes were performed. After the surgery, adjuvant chemotherapy with FOLFOX was administered. Afterwards, the patient developed severe anal pain and visited us for treatment. The severe anal pain continued even after FOLFOX treatment and increased with defecation. A side effect of oxaliplatin was suspected, and sLV5FU chemotherapy was administered. As a result, the anal pain disappeared. Thus, the pain was considered to be induced by oxaliplatin. While peripheral neuropathy is a widely known side effect of oxaliplatin, this case was considered to be unique because anal pain occurs very rarely with oxaliplatin treatment.
要旨
症例は28歳,女性。骨盤内を占拠する直腸癌を認め,術前化学療法としてSOX+Cmab療法を2コースとFOLFOX+Cmab療法を4コース行い,主病巣の縮小を認めた後に腹腔鏡下低位前方切除術,両側側方リンパ節郭清術を施行した。術後にFOLFOXによる補助化学療法を実施したところ,激しい肛門部痛を訴え来院した。その後のFOLFOX治療後にも激しい肛門部痛を認め,排便により痛みは増強した。オキサリプラチンによる副作用を疑いsLV5FUによる補助化学療法を実施したところ肛門部痛の出現はいっさい認めず,オキサリプラチンに誘導された肛門部痛と断定した。オキサリプラチンによる末梢神経障害は広く知られた副作用であるが,肛門部痛を呈することは非常にまれで貴重な症例と考えられた。