内容紹介
Summary
We report a case of colostomy-free, long-term survival following 5-FU/CDDP for the local recurrence of anal cancer after chemoradiation therapy(CRT). The patient was a 48-year-old woman who was diagnosed with cStage ⅢA anal cancer. She was treated with CRT(5-FU/MMC plus 59 Gy)and achieved a complete response upon treatment completion. A local recurrence was detected on the left-side wall of her rectum after 6 months. We recommended abdominoperineal resection but the patient refused operation. The patient was treated with chemotherapy consisting of 5-FU(1,000 mg/m2/day)on days 1-5 and CDDP(100 mg/m2/day)on day 2. Grade 3 peripheral neuropathy appeared following the completion of 5 courses. Therefore, the dose was reduced to 60%. Twenty-five courses of this treatment were continued and chemotherapy was completed. The patient has been alive with no sign of recurrence for 6 years and 8 months from the initial treatment. CRT for anal cancer is becoming a standard therapy but local recurrence is possible. In these cases, abdominoperineal resection is required. Chemotherapy with 5-FU/CDDP in cases of recurrence can be a colostomy-free option.
要旨
今回われわれは,肛門扁平上皮癌の化学放射線療法(chemoradiation therapy: CRT)後の局所再発に対して5-FU/CDDP療法により完全奏効(complete response: CR)し,肛門温存,長期生存が得られた症例を経験したので報告する。症例は48歳,女性,肛門から上部直腸の肛門扁平上皮癌,cStage ⅢA(cT3N1M0)に対してCRTとして5-FU/MMC+59 Gyを施行しCRを得た。6か月後の定期検査で直腸左側壁に局所再発が判明し,手術治療も考慮したが肛門温存を希望したため,5-FU/CDDPによる化学療法を施行した。途中Grade 3の末梢神経障害を認めたが,減量して継続したところCRが得られ,初回治療から6年8か月経過した現在,無再発生存中である。肛門扁平上皮癌に対してCRTは標準治療となりつつあるが,局所再発も少なくなく腹会陰式直腸切断術を要する。CRT後の再発治療において化学療法は,肛門温存を希望する場合に選択の一つになり得る。
目次
We report a case of colostomy-free, long-term survival following 5-FU/CDDP for the local recurrence of anal cancer after chemoradiation therapy(CRT). The patient was a 48-year-old woman who was diagnosed with cStage ⅢA anal cancer. She was treated with CRT(5-FU/MMC plus 59 Gy)and achieved a complete response upon treatment completion. A local recurrence was detected on the left-side wall of her rectum after 6 months. We recommended abdominoperineal resection but the patient refused operation. The patient was treated with chemotherapy consisting of 5-FU(1,000 mg/m2/day)on days 1-5 and CDDP(100 mg/m2/day)on day 2. Grade 3 peripheral neuropathy appeared following the completion of 5 courses. Therefore, the dose was reduced to 60%. Twenty-five courses of this treatment were continued and chemotherapy was completed. The patient has been alive with no sign of recurrence for 6 years and 8 months from the initial treatment. CRT for anal cancer is becoming a standard therapy but local recurrence is possible. In these cases, abdominoperineal resection is required. Chemotherapy with 5-FU/CDDP in cases of recurrence can be a colostomy-free option.
要旨
今回われわれは,肛門扁平上皮癌の化学放射線療法(chemoradiation therapy: CRT)後の局所再発に対して5-FU/CDDP療法により完全奏効(complete response: CR)し,肛門温存,長期生存が得られた症例を経験したので報告する。症例は48歳,女性,肛門から上部直腸の肛門扁平上皮癌,cStage ⅢA(cT3N1M0)に対してCRTとして5-FU/MMC+59 Gyを施行しCRを得た。6か月後の定期検査で直腸左側壁に局所再発が判明し,手術治療も考慮したが肛門温存を希望したため,5-FU/CDDPによる化学療法を施行した。途中Grade 3の末梢神経障害を認めたが,減量して継続したところCRが得られ,初回治療から6年8か月経過した現在,無再発生存中である。肛門扁平上皮癌に対してCRTは標準治療となりつつあるが,局所再発も少なくなく腹会陰式直腸切断術を要する。CRT後の再発治療において化学療法は,肛門温存を希望する場合に選択の一つになり得る。