Okamoto Ken, Kobayashi Michiya, Maeda Hiromichi, Takeshita Atsunori
Dept. of Human Health and Medical Sciences, Kochi Medical School, Japan.
Gan To Kagaku Ryoho. 2012 Jul;39(7):1151-3.
A 61-year-old man on hemodialysis due to chronic renal failure caused by diabetes mellitus was diagnosed as having ascending colon cancer with multiple liver metastases. Colonoscopy revealed a Type 2 tumor located in the ascending colon. Abdominal CT showed hepatic tumors in S8 measuring 8×7 cm and in S6 measuring 5×4 cm, with a number of small tumors in the other sites. In order to prevent a hemorrhage from the colonic tumor, laparoscope-assisted right colectomy was performed. Seventeen days after the operation, oral administration of tegafur uracil(300mg/body/day)and calcium folinate(75mg/body/day)was initiated for the treatment of hepatic metastases. After three courses of treatment, size reduction of the hepatic metastases(the S8 4×3. 5 cm and the S6 2. 5×2. 5 cm)was obtained. Although nine months with seven courses of chemotherapy had passed without significant side effects, the size of hepatic metastases increased. Currently, therefore, CPT-11 and cetuximab are being administered as second-line treatment.
一名61岁男性因糖尿病所致慢性肾衰竭接受血液透析，被诊断为升结肠癌伴多发肝转移。结肠镜检查显示升结肠有一处2型肿瘤。腹部CT显示肝S8段有一个8×7cm的肿瘤，S6段有一个5×4cm的肿瘤，其他部位还有一些小肿瘤。为防止结肠肿瘤出血，实施了腹腔镜辅助右半结肠切除术。术后17天，开始口服替加氟尿嘧啶（300mg/日/人）和亚叶酸钙（75mg/日/人）以治疗肝转移。经过三个疗程的治疗，肝转移灶缩小（S8段变为4×3.5cm，S6段变为2.5×2.5cm）。尽管已进行了七个疗程的化疗，历时九个月且无明显副作用，但肝转移灶的大小仍增大了。因此，目前正在给予伊立替康和西妥昔单抗作为二线治疗。
