Cavanna L, Bertè R, Bidin L, Civardi G, Anselmi E, Lazzaro A, Moroni C F, Palladino M A, Rodinò C, Vallisa D
Department of Medical Oncology and Hematology, Hospital Guglielmo da Saliceto, Piacenza, Italy.
J Chemother. 2005 Jun;17(3):334-8. doi: 10.1179/joc.2005.17.3.334.
Metastatic/advanced colorectal cancer is considered a resistant disease and oncologic emergencies secondary to advanced disease may be regarded with a nihilistic attitude. The objective of this report is to emphasize the efficacy of the oxaliplatin/5-fluorouracil/leucovorin regimen (FOLFOX-4) in three patients presenting oncologic emergencies secondary to advanced colon cancer. The first case was a 40-year-old man with severe respiratory insufficiency due to massive carcinomatous lymphangitis; subsequently a cecal adenocarcinoma was diagnosed. The patient's conditions became life-threatening and he was admitted to the intensive care unit. The second case was a 41-year-old woman presenting with fever, abdominal mass and pain. Ultrasound and CT-scan revealed two hepatic masses (13 x 15 and 15 x 20 cm), diagnosed as liver metastases from colon cancer. The patient's condition deteriorated with intestinal obstruction secondary to the large left liver mass. The third case was a 58-year-old woman presenting with hepatic mass, fever and weight loss. Ultrasound and CT-scan showed a liver lesion occupying the right lobe (12 x 14 cm). Ultrasonically-guided biopsy and colonoscopy showed liver metastases from cecal cancer. A 5-fluorouracil/leucovorin regimen failed to improve her clinical condition and she had disease progression, inferior vena cava neoplastic thrombosis and right hydronephrosis. All three patients rapidly improved after a few cycles of oxaliplatin-containing chemotherapy. These cases demonstrate that even patients with advanced colorectal cancer presenting with oncologic emergencies and life-threatening conditions can be successfully treated with the FOLFOX-4 regimen.
转移性/晚期结直肠癌被认为是一种难治性疾病，对于由晚期疾病引发的肿瘤急症可能会持消极态度。本报告的目的是强调奥沙利铂/5-氟尿嘧啶/亚叶酸钙方案（FOLFOX-4）对三名因晚期结肠癌引发肿瘤急症的患者的疗效。首例患者为一名40岁男性，因广泛癌性淋巴管炎导致严重呼吸功能不全；随后被诊断为盲肠腺癌。患者病情危及生命，被收入重症监护病房。第二例患者是一名41岁女性，伴有发热、腹部肿块和疼痛。超声和CT扫描显示有两个肝脏肿块（13×15和15×20厘米），诊断为结肠癌肝转移。患者病情因左肝大肿块继发肠梗阻而恶化。第三例患者是一名58岁女性，有肝脏肿块、发热和体重减轻症状。超声和CT扫描显示右叶有一个肝脏病变（12×14厘米）。超声引导下活检和结肠镜检查显示为盲肠癌肝转移。5-氟尿嘧啶/亚叶酸钙方案未能改善她的临床状况，且病情进展，出现下腔静脉肿瘤性血栓形成和右肾积水。所有三名患者在接受几个周期含奥沙利铂的化疗后均迅速好转。这些病例表明，即使是患有肿瘤急症和危及生命状况的晚期结直肠癌患者，也可以通过FOLFOX-4方案成功治疗。
