Watanabe Masashi, Tsuchiya Masaru, Takita Wataru, Otsuka Yuichiro, Tamura Akira, Yamazaki Kunihiro, Koshino Hideyuki, Kurihara Akiharu, Kaneko Hironori, Teramoto Tatsuo
Dept. of Gastrointestinal Surgery, Toho University Medical Center, Omori Hospital.
Gan To Kagaku Ryoho. 2006 Oct;33(10):1485-8.
A 67-year-old woman, who was diagnosed with rectal cancer and liver metastasis, underwent a low anterior resection of the rectum in May 2004. Two months later, the level of tumor markers increased and a CT scan revealed a 45 x 35 mm liver metastasis in the S(8) segment. She was referred to our hospital for treatment of the liver tumor. Intra-hepatic arterial infusion of irinotecan (CPT-11) and mitomycin C (MMC) with degradable starch microspheres (DSM) was given in July 2004. Following this, a 34-week course of weekly high-dose intra-hepatic arterial 5-FU infusion (5-FU 1,000 mg/m(2)) was performed. In April 2005, the size of the liver metastasis decreased, and the level of serum tumor marker normalized. A CT and echo scan revealed a calcified tumor, and therefore all chemotherapy was stopped. She was followed in the outpatient clinic, with no evidence of recurrence for 12 months. This case suggests that the use of intra-hepatic arterial infusion of CPT-11 and MMC with DSM is useful for the treatment of liver metastases in colorectal cancer.
一名67岁女性,被诊断为直肠癌伴肝转移,于2004年5月接受了直肠低位前切除术。两个月后,肿瘤标志物水平升高,CT扫描显示肝S(8)段有一个45×35 mm的肝转移灶。她因肝肿瘤治疗被转诊至我院。2004年7月给予肝动脉内灌注伊立替康(CPT-11)、丝裂霉素C(MMC)及可降解淀粉微球(DSM)。此后,进行了为期34周的每周一次高剂量肝动脉内5-氟尿嘧啶灌注(5-氟尿嘧啶1000 mg/m(2))。2005年4月,肝转移灶大小减小,血清肿瘤标志物水平恢复正常。CT和超声扫描显示肿瘤钙化,因此停止了所有化疗。她在门诊接受随访,12个月无复发迹象。该病例提示,肝动脉内灌注CPT-11、MMC及DSM对治疗结直肠癌肝转移有效。