Maeda Kiyoshi, Noda Eiji, Nagahara Hisashi, Inoue Toru, Kashiwagi Shinichiro, Fuyuhiro Yuhiko, Nakamoto Kentaro, Hirakawa Kosei
Dept. of Surgical Oncology, Osaka City University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2011 Aug;38(8):1297-300.
Seven patients with rectal cancers which were difficult to ensure surgical margins for because of huge tumors(over 60mm in diameter), invasion to other organs, or severe nodal metastases, were treated with preoperative chemotherapy consisting of 2-10 courses of mFOLFOX6.The response rate was 85. 7%.Complete response was observed in one patient, and partial response was observed in 5 patients.Four to 5 weeks after chemotherapy, surgery was performed for all patients.Following surgical procedures, abdominoperineal resections were performed in 4 cases, low anterior resections in 3 cases, and removal of the liver metastases(not diagnosed preoperatively)in 2 cases.R0 resections were also performed in all patients. According to the histological regression grading of the resected specimens, one patient had a complete disappearance of tumor, 5 had grade 1a regression, and one had grade 1b regression.One of the 7 patients had recurrence at the lung. However, another patient survived without recurrence. In this study, preoperative mFOLFOX6 chemotherapy was expected to be an effective treatment for improving the curative resection rate of patients with tumors which were difficult to ensure surgical margins because of huge tumors, invasion to other organs, or severe nodal metastases.
7例因肿瘤巨大（直径超过60mm）、侵犯其他器官或有严重淋巴结转移而难以确保手术切缘的直肠癌患者，接受了由2 - 10个疗程的mFOLFOX6组成的术前化疗。有效率为85.7%。1例患者达到完全缓解，5例患者达到部分缓解。化疗后4至5周，所有患者均接受了手术。手术后，4例行腹会阴联合切除术，3例行低位前切除术，2例切除肝转移灶（术前未诊断出）。所有患者均进行了R0切除。根据切除标本的组织学退缩分级，1例患者肿瘤完全消失，5例为1a级退缩，1例为1b级退缩。7例患者中有1例出现肺部复发。然而，另1例患者无复发存活。在本研究中，术前mFOLFOX6化疗有望成为一种有效的治疗方法，可提高因肿瘤巨大、侵犯其他器官或有严重淋巴结转移而难以确保手术切缘的患者的根治性切除率。
