Kuga Yoshio, Tanaka Tomotaka, Arita Michinori, Okanobu Hideharu, Miwata Tomohiro, Yoshimi Satoshi, Murakami Eisuke, Numata Yoshihiro, Moriya Takashi, Ohya Toshihide, Nishida Toshihiro
Dept. of Internal Medicine, Japan Labour Health and Welfare Organization.
Gan To Kagaku Ryoho. 2010 Mar;37(3):531-4.
The patient was a 75-year-old man who was admitted because of diarrhea and anemia. Endoscopic examination revealed advanced sigmoid colon cancer. Serum CEA levels were markedly elevated. In July 2007, surgery was performed, but the sigmoid colon cancer was unresectable. After surgery, the patient was treated with chemotherapy and concurrent radiotherapy. The chemotherapy consisted of oral UFT (420 mg/body/day)and Leucovorin (75 mg/body/day) administered for 6 weeks. Radiotherapy at 2 Gy/day was administered 30 times (total dose 60 Gy). The tumor decreased slightly in size and serum CEA levels also decreased. The patient refused surgery as an additional therapy. In August 2007, we started combination chemotherapy using oral S-1 (100 mg/body/day, day 1-14) and intravenous CPT-11 (140 mg/body/day, day 1 and 15) as one course for 4 weeks. After 4 courses, serum CEA levels were normal, the sigmoid colon cancer was not found by endoscopy and a biopsy specimen revealed no malignant cells. Moreover, after 8 courses, the tumor disappeared, as confirmed by computed tomography (CT) and positron emission tomography-CT, representing a complete response. Chemoradiotherapy using UFT and Leucovorin, and chemotherapy consisting of S-1 and CPT-11 as an additional therapy may be effective for treating unresectable advanced sigmoid colon cancer.
该患者为一名75岁男性，因腹泻和贫血入院。内镜检查发现乙状结肠癌进展期。血清癌胚抗原（CEA）水平显著升高。2007年7月进行了手术，但乙状结肠癌无法切除。术后，患者接受了化疗及同步放疗。化疗方案为口服优福定（UFT，420mg/体/天）和亚叶酸钙（75mg/体/天），持续6周。放疗剂量为2Gy/天，共30次（总剂量60Gy）。肿瘤体积略有缩小，血清CEA水平也有所下降。患者拒绝进一步手术治疗。2007年8月，我们开始使用口服替吉奥（S-1，100mg/体/天，第1 - 14天）和静脉注射伊立替康（CPT-11，140mg/体/天，第1天和第15天）联合化疗，每4周为一个疗程。4个疗程后，血清CEA水平恢复正常，内镜检查未发现乙状结肠癌，活检标本未发现恶性细胞。此外，8个疗程后，经计算机断层扫描（CT）和正电子发射断层扫描-CT证实肿瘤消失，达到完全缓解。使用优福定和亚叶酸钙的放化疗，以及使用替吉奥和伊立替康的化疗作为进一步治疗手段，可能对治疗无法切除的晚期乙状结肠癌有效。
