内容紹介
Summary
A 73-year-old woman presenting with weight loss was diagnosed as having ascending colon cancer with synchronous liver metastasis. The liver metastasis was solitary but it occupied the medial and anterior segments. The size was over 9 cm in diameter and was located adjacent to the left, middle, and right hepatic veins, making it initially unresectable. Following surgical resection of the primary tumor, she received mFOLFOX6 plus bevacizumab chemotherapy, resulting in a decrease in size of the liver metastasis. During the 15 courses of chemotherapy, an allergic reaction to oxaliplatin occurred and oxaliplatin administration was stopped. Although the liver metastasis was considered to be in a stable disease state according to the RECIST criteria at the time following 32 courses of chemotherapy, we discontinued chemotherapy due to various reasons of the patient. However, the liver metastasis continues to be in the stable disease state, and has not grown for over 5 years since initiating mFOLFOX6 plus bevacizumab chemotherapy and for over 3 years since discontinuing the chemotherapy.
要旨
症例は73歳,女性。体重減少を主訴に受診され,精査で上行結腸癌および同時性肝転移と診断された。肝転移巣は単発であったが内側区域から前区域にかけて最大径9 cmを超える大きさであり,左,中,右すべての肝静脈と密に接していたため初回切除不能と判断した。肝転移に対しては化学療法の方針とし,原発巣の切除後にmFOLFOX6+bevacizumabによる化学療法を開始した。化学療法により肝転移の縮小を得たが,15コース目でoxaliplatinによるアレルギーが起こり,以後はoxaliplatinを中止した。32コース終了時もRECIST基準でSDであったが,患者側の事情により化学療法を終了することになった。化学療法終了後も肝転移の増大および新規病変の出現は認めず,化学療法を開始して5年,化学療法を中止して3年が経過した現在も化学療法を再開していない。
目次
A 73-year-old woman presenting with weight loss was diagnosed as having ascending colon cancer with synchronous liver metastasis. The liver metastasis was solitary but it occupied the medial and anterior segments. The size was over 9 cm in diameter and was located adjacent to the left, middle, and right hepatic veins, making it initially unresectable. Following surgical resection of the primary tumor, she received mFOLFOX6 plus bevacizumab chemotherapy, resulting in a decrease in size of the liver metastasis. During the 15 courses of chemotherapy, an allergic reaction to oxaliplatin occurred and oxaliplatin administration was stopped. Although the liver metastasis was considered to be in a stable disease state according to the RECIST criteria at the time following 32 courses of chemotherapy, we discontinued chemotherapy due to various reasons of the patient. However, the liver metastasis continues to be in the stable disease state, and has not grown for over 5 years since initiating mFOLFOX6 plus bevacizumab chemotherapy and for over 3 years since discontinuing the chemotherapy.
要旨
症例は73歳,女性。体重減少を主訴に受診され,精査で上行結腸癌および同時性肝転移と診断された。肝転移巣は単発であったが内側区域から前区域にかけて最大径9 cmを超える大きさであり,左,中,右すべての肝静脈と密に接していたため初回切除不能と判断した。肝転移に対しては化学療法の方針とし,原発巣の切除後にmFOLFOX6+bevacizumabによる化学療法を開始した。化学療法により肝転移の縮小を得たが,15コース目でoxaliplatinによるアレルギーが起こり,以後はoxaliplatinを中止した。32コース終了時もRECIST基準でSDであったが,患者側の事情により化学療法を終了することになった。化学療法終了後も肝転移の増大および新規病変の出現は認めず,化学療法を開始して5年,化学療法を中止して3年が経過した現在も化学療法を再開していない。