Ishihara K, Tanemura H, Ohshita H, Kanno A, Kusakabe M, Hatou T, Tonomura S, Hosono Y, Sasaki Y
Dept. of Surgery, Gifu Municipal Hospital.
Gan To Kagaku Ryoho. 2001 Oct;28(11):1776-9.
A 62-year-old female patient, who was diagnosed with sigmoid colon cancer with multiple liver metastases, was admitted to our hospital. She underwent sigmoidectomy with D3 lymph node dissection on January 31, 2000. In addition to that, she received hepatic intra-arterial infusion of levoforinate (l-LV) 250 mg and 5-fluorouracil (5-FU) 500 mg for combined multiple hepatic metastases starting on postoperative day 14, and these medications were administered over 48 hours once weekly by infuser pump. The tumor diminished by 59% 2 months after the start of administration and further diminished at 4 months. PR was achieved. Cancer metastasis to the cerebellum and metastasis to the lung were detected at month 9 and month 11, respectively, but the liver metastatic tumor continued to diminish in size, ultimately becoming undetectable by CT scan at month 10. Surgery and radiotherapy were performed for the cerebellar metastasis, and intravenous administration of a combination of l-LV and 5-FU was performed systemically for the pulmonary metastatic tumor. At present, the patient receives regular outpatient treatment continuously. To our knowledge, there has been no report on the combination therapy with l-LV and 5-FU through the hepatic artery. Since good antitumor efficacy was demonstrated in the present patient, this case is described in this report together with four other cases of hepatic metastasis from colorectal cancer.
一名62岁女性患者,被诊断为乙状结肠癌伴多发肝转移,入住我院。2000年1月31日,她接受了乙状结肠切除术及D3淋巴结清扫术。此外,术后第14天起,她接受肝动脉内输注亚叶酸钙(l-LV)250mg和5-氟尿嘧啶(5-FU)500mg,用于治疗多发肝转移,这些药物通过输液泵每周一次在48小时内输注。给药开始2个月后肿瘤缩小了59%,4个月时进一步缩小。达到了部分缓解(PR)。分别在第9个月和第11个月检测到癌症转移至小脑和肺,但肝转移瘤的大小持续缩小,最终在第10个月时CT扫描无法检测到。对小脑转移灶进行了手术和放疗,对肺转移瘤进行了l-LV和5-FU联合静脉全身给药。目前,该患者持续接受定期门诊治疗。据我们所知,尚无关于通过肝动脉联合使用l-LV和5-FU进行治疗的报道。由于本患者显示出良好的抗肿瘤疗效,本报告将该病例与其他4例结直肠癌肝转移病例一起进行描述。