Egi Hiroyuki, Okajima Masazumi, Takakura Yuji, Nakahara Hideki, Matsugu Yasuhiro, Kohashi Toshihiko, Kadoya Takayuki, Ohmori Ichiro, Urushihara Takashi, Itamoto Toshiyuki
Dept. of General Surgery, Hiroshima Prefectural Hospital.
Gan To Kagaku Ryoho. 2009 Nov;36(11):1911-4.
A 78-year-old female underwent an abdomino-perineal resection for lower rectal cancer with para-aortic, right iliac artery and left inguinal lymph node metastasis. Two weeks later, an enlargement of para-aortic and right iliac artery lymph node metastasis was detected by CT. S-1 (100 mg/day for 2 weeks followed by a 1-week rest period) + CPT-11 (120 mg/m2, day 1)treatment was initially administered. However, the patient developed grade 2 anorexia so this treatment regimen was terminated. After complete recovery from the adverse reaction, the regimen was converted to S-1 administration at 100mg/day S-1 for 2 weeks followed by a 1-week rest period. Eventually, this schedule was modified to 100mg/day for 1 week followed by a 1-week rest period. A year after the operation, CT revealed the lymph node metastasis to have disappeared, and no relapse occurred for 32 months. This was a successful case in which S-1 yielded an extended complete response for advanced rectal cancer. Treatment with S-1 is an effective choice for patients who for various reasons can not tolerate the standard treatment for unresectable advanced colorectal cancer. Moreover, randomized controlled trials have to be started to evaluate the efficacy of S-1 treatment for advanced rectal cancer as soon as possible.
一名78岁女性因低位直肠癌伴腹主动脉旁、右髂动脉及左腹股沟淋巴结转移接受了腹会阴联合切除术。两周后，CT检查发现腹主动脉旁及右髂动脉淋巴结转移灶增大。最初给予S-1（100mg/天，连用2周，随后休息1周）+CPT-11（120mg/m²，第1天）治疗。然而，患者出现了2级厌食症，因此终止了该治疗方案。在不良反应完全恢复后，治疗方案改为S-1 100mg/天，连用2周，随后休息1周。最终，该方案改为100mg/天，连用1周，随后休息1周。术后一年，CT显示淋巴结转移灶消失，32个月未复发。这是一例S-1对晚期直肠癌产生延长完全缓解的成功病例。对于因各种原因不能耐受不可切除晚期结直肠癌标准治疗的患者，S-1治疗是一种有效的选择。此外，必须尽快开展随机对照试验，以评估S-1治疗晚期直肠癌的疗效。
