Matsutani Takeshi, Sasajima Koji, Suzuki Seiji, Matsushita Akira, Maruyama Hiroshi, Matsuda Akihisa, Miyamoto Masayuki, Yokoyama Tadashi, Sugiura Atsushi, Yanagi Ken, Nishi Yoshifumi, Arai Hiroki, Wakabayashi Hideyuki, Tajiri Takashi
Dept. of Surgery, Nippon Medical School Tama-Nagayama Hospital.
Gan To Kagaku Ryoho. 2009 Mar;36(3):505-7.
A 58-year-old woman underwent right hemicolectomy with lymph node dissection(D2)for advanced ascending colon cancer which pathological examinations revealed to be moderately-differentiated adenocarcinoma. CEA and CA19-9 levels increased 6 months after the operation. She started adjuvant chemotherapy with oral administration of UFT-E(400 mg/day), but CEA and CA19-9 levels continued to elevate. However, a recurrent tumor was not detected by computed tomography(CT)and endoscopic examinations. A local recurrence in the right lateral abdominal wall was confirmed by PET-CT examination. We then conducted modified-FOLFOX6/FOLFIRI alternating regimen(modified- FIREFOX regimen). After this therapy, repeated PET-CT showed that the abnormal FDG-uptake concentration had disappeared, leading to a complete response(CR). The adverse event was grade 3 in leucopenia and grade 2 in gastrointestinal toxicity. She had maintained CR for the 12 months since undergoing chemotherapy. CEA and CA19-9 levels reduced to the normal range. We report this case with some review of the literature.
一名58岁女性因进展期升结肠癌接受了右半结肠切除术及淋巴结清扫术（D2），病理检查显示为中分化腺癌。术后6个月癌胚抗原（CEA）和糖类抗原19-9（CA19-9）水平升高。她开始口服优福定（UFT-E，400毫克/天）进行辅助化疗，但CEA和CA19-9水平持续升高。然而，计算机断层扫描（CT）和内镜检查均未发现复发性肿瘤。正电子发射断层显像-CT（PET-CT）检查证实右侧腹壁局部复发。随后我们采用改良FOLFOX6/FOLFIRI交替方案（改良FIREFOX方案）进行治疗。该治疗后，重复PET-CT显示异常的氟代脱氧葡萄糖（FDG）摄取浓度消失，达到完全缓解（CR）。不良事件为3级白细胞减少和2级胃肠道毒性。自化疗后12个月以来她一直维持完全缓解状态。CEA和CA19-9水平降至正常范围。我们报告此病例并对相关文献进行一些回顾。
