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1例经伊立替康联合5-氟尿嘧啶及亚叶酸钙联合化疗后行根治性切除治疗的乙状结肠癌伴主动脉旁淋巴结转移病例

[A case of sigmoid colon cancer with metastases of para-aortic lymph nodes treated with curative resection after irinotecan plus 5-fluorouracil and l-leucovorin combination chemotherapy].

作者信息

Nakamura Koichi, Nakamura Toshio, Kurachi Kiyotaka, Fukazawa Atsuko, Hayashi Tadataka, Nakajima Akihito, Suzuki Shohachi, Konno Hiroyuki

机构信息

Second Dept. of Surgery, Hamamatsu University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 2008 Jun;35(6):1017-20.

Abstract

A 54-year-old woman visited our hospital with a chief complaint of lower abdominal pain and melena. The patient was diagnosed with sigmoid colon cancer using colonoscopy. Abdominal CT revealed metastases to para-aortic lymph node, so our diagnosis was unresectable sigmoid colon cancer. She underwent a transverse colostomy to avoid stenosis. Two weeks after surgery, she underwent a 1-week chemotherapy regimen (CPT-11 80 mg/m(2)/week+5-FU 2,000 mg/m(2)/week+l-LV 250 mg/m(2)/week) modified AIO regimen combined irinotecan for 3 weeks, followed by a 1-week rest interval as one course. Throughout the period of treatment, there was no adverse event, and this regimen has been maintained for 5 courses. After 5 courses of chemotherapy, primary tumor and metastases to para-aortic lymph nodes were remarkably reduced on colonoscopy and abdominal CT. So, she could undergo curative resection. Pathological efficacy was Grade 3, a complete response. This combination therapy may well be useful for advanced colon cancer patients.

摘要

一名54岁女性因下腹部疼痛和黑便前来我院就诊。通过结肠镜检查,该患者被诊断为乙状结肠癌。腹部CT显示腹主动脉旁淋巴结转移,因此我们的诊断为不可切除的乙状结肠癌。她接受了横结肠造口术以避免狭窄。术后两周,她接受了为期1周的化疗方案(CPT - 11 80 mg/m²/周 + 5 - FU 2000 mg/m²/周 + l - LV 250 mg/m²/周),这是改良的AIO方案联合伊立替康,持续3周,随后休息1周为一个疗程。在整个治疗期间,未出现不良事件,该方案已维持了5个疗程。经过5个疗程的化疗后,结肠镜检查和腹部CT显示原发肿瘤及腹主动脉旁淋巴结转移明显缩小。因此,她能够接受根治性切除。病理疗效为3级,即完全缓解。这种联合治疗可能对晚期结肠癌患者非常有用。

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