内容紹介
Summary
A 66—year—old male diagnosed with transverse colon cancer was admitted to our hospital. Computed tomography, colonoscopy, and esophagogastroduodenoscopy revealed locally advanced cancer with invasion of the gastric antrum. We staged the disease as cT4a, cN2, cM0, Stage ⅢB, with wild—type RAS expression. We performed an ileostomy prior to administering chemotherapy. The patient received 4 courses of modified FOLFOXIRI plus bevacizumab and 2 courses of FOLFIRI. The size of the tumor noticeably decreased after chemotherapy. The patient experienced grade 3 neutropenia, anorexia, and oral mucositis during chemotherapy. We performed a right hemicolectomy(D3), partial gastrectomy and ileum resection after administering neoadjuvant chemotherapy. The pathological stage of the disease was ypT2, ypN0, ypM0, ypStageⅠ, and the effect of the chemotherapy was Grade 1b. After the resection, he received mFOLFOX6 and CapeOX for 3 months as adjuvant chemotherapy. He remained cancer—free for 1 year and 3 months after the surgery. This result suggests that preoperative modified FOLFOXIRI plus bevacizumab chemotherapy is a useful regimen for the treatment of locally advanced colon cancer.
要旨
症例は66歳,男性。胃前庭部への浸潤を伴う横行結腸癌,cT4(SI,胃),cN2,cM0,Stage ⅢB(大腸癌取扱い規約第8版)に対して,回腸人工肛門を造設後,術前にmFOLFOXIRI+bevacizumab療法4コースとFOLFIRI療法2コースを施行し根治切除を行った。Grade 3以上の副作用は好中球減少と口腔粘膜炎,食思不振を認めた。術後病理組織学的診断ではypT2(MP),ypN0,ypM0,ypStage Ⅰと診断された。術後に3か月補助化学療法を行い,現在術後1年3か月を経過し無再発である。術前のmFOLFOXIRI+bevacizumab療法は進行大腸癌に対して有用である可能性が示唆された。
目次
A 66—year—old male diagnosed with transverse colon cancer was admitted to our hospital. Computed tomography, colonoscopy, and esophagogastroduodenoscopy revealed locally advanced cancer with invasion of the gastric antrum. We staged the disease as cT4a, cN2, cM0, Stage ⅢB, with wild—type RAS expression. We performed an ileostomy prior to administering chemotherapy. The patient received 4 courses of modified FOLFOXIRI plus bevacizumab and 2 courses of FOLFIRI. The size of the tumor noticeably decreased after chemotherapy. The patient experienced grade 3 neutropenia, anorexia, and oral mucositis during chemotherapy. We performed a right hemicolectomy(D3), partial gastrectomy and ileum resection after administering neoadjuvant chemotherapy. The pathological stage of the disease was ypT2, ypN0, ypM0, ypStageⅠ, and the effect of the chemotherapy was Grade 1b. After the resection, he received mFOLFOX6 and CapeOX for 3 months as adjuvant chemotherapy. He remained cancer—free for 1 year and 3 months after the surgery. This result suggests that preoperative modified FOLFOXIRI plus bevacizumab chemotherapy is a useful regimen for the treatment of locally advanced colon cancer.
要旨
症例は66歳,男性。胃前庭部への浸潤を伴う横行結腸癌,cT4(SI,胃),cN2,cM0,Stage ⅢB(大腸癌取扱い規約第8版)に対して,回腸人工肛門を造設後,術前にmFOLFOXIRI+bevacizumab療法4コースとFOLFIRI療法2コースを施行し根治切除を行った。Grade 3以上の副作用は好中球減少と口腔粘膜炎,食思不振を認めた。術後病理組織学的診断ではypT2(MP),ypN0,ypM0,ypStage Ⅰと診断された。術後に3か月補助化学療法を行い,現在術後1年3か月を経過し無再発である。術前のmFOLFOXIRI+bevacizumab療法は進行大腸癌に対して有用である可能性が示唆された。