Ochiai Takanori, Maruyama Michio, Ebuchi Masakazu, Nagahama Takeshi, Takashima Itaru, Hasegawa Kumi, Natsui Shinsuke, Sakoma Takaaki
Dept. of Surgery, Tokyo Metropolitan Ohkubo Hospital.
Gan To Kagaku Ryoho. 2002 Nov;29(12):2080-3.
A 46-year-old man underwent polypectomy of sigmoid colon in January 1996. The adenocarcinoma invaded the submucosal layer, and sigmoidectomy and D2 lymph node dissection were performed one month later. Follow-up CT revealed liver metastases, and partial hepatectomy was performed in January 1998. Afterward, weekly high dose intra-hepatic arterial chemotherapy (5-FU: 1,000 mg/body) was performed 41 times, but CT revealed multiple liver metastases in October 1998. Therefore, intra-hepatic arterial infusion of mitomycin C (MMC) with degradable starch microspheres (DSM) was given in November 1998. As follow-up CT revealed that the liver metastases were growing, partial hepatectomy was performed again in March 1999. No carcinoma was seen in the resected liver. After the second hepatectomy, intra-hepatic arterial infusion of MMC with DSM was performed five times. No evidence of recurrence has been seen. Intra-hepatic arterial infusion of MMC with DSM is recommended for liver metastases of colorectal cancer as a second line treatment.
一名46岁男性于1996年1月接受了乙状结肠息肉切除术。腺癌侵犯至黏膜下层,1个月后进行了乙状结肠切除术及D2淋巴结清扫术。随访CT显示肝转移,于1998年1月进行了部分肝切除术。此后,每周进行1次高剂量肝动脉化疗(5-氟尿嘧啶:1000mg/体),共进行41次,但1998年10月CT显示出现多发肝转移。因此,1998年11月给予肝动脉灌注丝裂霉素C(MMC)与可降解淀粉微球(DSM)。随访CT显示肝转移灶增大,1999年3月再次进行了部分肝切除术。切除的肝脏中未见癌组织。第二次肝切除术后,进行了5次肝动脉灌注MMC与DSM。未见复发迹象。推荐将肝动脉灌注MMC与DSM作为结直肠癌肝转移的二线治疗方法。