Department of Surgical Oncology, Oncologisch Centrum UZ Brussel, Brussels, Belgium.
Curr Oncol. 2011 Oct;18(5):e256-9. doi: 10.3747/co.v18i5.789.
At diagnosis of a cT3N0M1 adenocarcinoma of the rectum with synchronous inoperable liver metastases, a 59-year-old man was treated with preoperative radiotherapy (5×5 Gy), followed by laparoscopy-assisted anterior resection of the rectum with total mesorectal excision. At the first postoperative evaluation, a new lung metastasis was detected. First-line chemotherapy with folfiri (5-fluorouracil, irinotecan, leucovorin) resulted in transient stabilization of the metastatic liver disease. At progression, oxaliplatin and 5-fluorouracil-folinic acid were administered by intrahepatic arterial infusion, in combination with intravenous cetuximab. A partial radiologic response was obtained, with complete metabolic response on fluorodeoxyglucose positron-emission tomography, and normalization of carcinoembryonic antigen values. The solitary lung metastasis was sequentially treated with radiotherapy and resection. Five years after the initial diagnosis, this patient remains free from progression, with residual cystic remnants of the liver metastases visible on conventional computed tomography imaging, but not enhancing with fluorodeoxyglucose positron-emission tomography.
一位 59 岁男性被诊断为直肠 cT3N0M1 腺癌，合并同步不可切除的肝转移。该患者接受了术前放疗（5×5 Gy），随后行腹腔镜辅助直肠前切除术和全直肠系膜切除术。在首次术后评估时，发现新的肺转移。患者接受一线化疗方案 folfiri（5-氟尿嘧啶、伊立替康、亚叶酸）治疗，转移性肝疾病暂时稳定。疾病进展时，采用奥沙利铂和氟尿嘧啶-亚叶酸经肝动脉输注联合静脉西妥昔单抗治疗。获得部分影像学缓解，氟脱氧葡萄糖正电子发射断层扫描显示完全代谢缓解，癌胚抗原值正常化。孤立性肺转移瘤随后接受放疗和切除术治疗。在初始诊断后的 5 年，该患者无疾病进展，常规计算机断层扫描显示肝转移的囊性残留，但氟脱氧葡萄糖正电子发射断层扫描无增强。
