Musha N, Nihei T, Watanabe N, Sunami E, Sasaki M, Saito H, Sando N, Oka K
Dept. of Surgery, Mito Saiseikai General Hospital.
Gan To Kagaku Ryoho. 2000 Feb;27(2):295-8.
A 59-year-old man was admitted to our hospital for advanced sigmoid colon carcinoma with synchronous multiple liver metastases. The patient received sigmoidectomy with regional lymph node dissection on June 8, 1998. We started intra-arterial combination chemotherapy on July 1, 1998. MMC (4 mg/body) was administered via rapid intra-arterial infusion on day 1. After MMC administration, 5-day intra-arterial continuous infusion of 5-FU at 500 mg/body/day was performed with oral administration of LV (30 mg/body/day). The treatment cycle was defined as every three weeks. The patient was treated with 4 courses of chemotherapy. From September 30, he received intra-arterial infusion of bolus MMC 4 mg/body, LV 6 mg/body and 5-FU 1,000 mg/body/4 hrs every two weeks with oral administration of Tegafur-uracil 400 mg/day. After 4 intra-arterial chemotherapy sessions, the metastatic liver tumors disappeared except for a focus in the right lobe. Therefore we decided to give the remnant liver metastasis percutaneous microwave coagulation therapy (PMCT). He obtained a complete remission in the liver metastases after two PMCT (70 W, 60 sec) sessions. Intra-arterial chemotherapy is effective for unresectable metastatic liver tumors from colon cancer. If a patient shows a partial response on the metastatic tumors through the chemotherapy, one must consider other modalities such as PMCT.
一名59岁男性因晚期乙状结肠癌伴同时性多发肝转移入院。患者于1998年6月8日接受了乙状结肠切除术及区域淋巴结清扫术。1998年7月1日开始进行动脉内联合化疗。第1天通过动脉内快速输注给予丝裂霉素(MMC,4mg/体)。给予MMC后,以500mg/体/天的剂量进行5天的5-氟尿嘧啶(5-FU)动脉内持续输注,并口服亚叶酸钙(LV,30mg/体/天)。治疗周期定义为每三周一次。患者接受了4个疗程的化疗。从9月30日起,他每两周接受一次动脉内推注MMC 4mg/体、LV 6mg/体和5-FU 1000mg/体/4小时,并口服替加氟-尿嘧啶400mg/天。经过4次动脉内化疗后,除右叶的一个病灶外,转移性肝肿瘤消失。因此,我们决定对残留的肝转移灶进行经皮微波凝固治疗(PMCT)。经过两次PMCT(70W,60秒)治疗后,他的肝转移灶完全缓解。动脉内化疗对无法切除的结肠癌肝转移瘤有效。如果患者通过化疗对转移瘤显示出部分缓解,必须考虑其他治疗方式,如PMCT。