Ishiyama Yasuhiro, Kotake Masanori, Matsunaga Masashi, Kitamura Hirotaka, Yamamoto Michihiro, Inaki Noriyuki, Kurokawa Masaru, Bando Hiroyuki, Yamada Tetsuji
Dept. of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Japan.
Gan To Kagaku Ryoho. 2012 Oct;39(10):1567-70.
Case 1 was a 58-year-old woman diagnosed with unresectable liver metastases from advanced rectal cancer. We performed laparoscopic low anterior resection for sigmoid cancer. As the first-line treatment, FOLFOX+bevacizumab(BV)was applied for 16 courses. The second-line treatment, FOLFIRI plus BV, was applied for four courses. However, the disease progressed with worsening liver metastases. The sequencing of K-RAS genes from the biopsy specimens of sigmoid colon cancer revealed an expression of a wild-type K-RAS. As the third-line treatment, panitumumab was applied. After 8 courses of this chemotherapy regimen, a significant reduction in the size of liver metastases was observed. Case 2 was an 81-year-old man diagnosed with unresectable liver metastases from advanced rectal cancer. We obliged the patient by performing laparoscopic rectal resection. As the first-line treatment, XELOX plus BV was applied for 10 courses. As the second-line treatment, IRIS was applied for 6 courses. However, this failed to prevent him from having a progressive disease. As the third-line treatment, panitumumab was applied for 2 courses, and a significant reduction in the size of liver metastases was observed. Our findings suggested that panitumumab has great potential for effective treatment of patients with unresectable stageIV colorectal cancer.
病例1是一名58岁女性,被诊断为晚期直肠癌伴不可切除的肝转移。我们对乙状结肠癌患者进行了腹腔镜低位前切除术。作为一线治疗方案,应用FOLFOX加贝伐单抗(BV)治疗16个疗程。二线治疗采用FOLFIRI加BV,治疗4个疗程。然而,疾病进展,肝转移恶化。对乙状结肠癌活检标本进行K-RAS基因测序,结果显示为野生型K-RAS表达。作为三线治疗,应用帕尼单抗。经过8个疗程的这种化疗方案后,观察到肝转移灶大小显著缩小。病例2是一名81岁男性,被诊断为晚期直肠癌伴不可切除的肝转移。我们为该患者实施了腹腔镜直肠切除术。作为一线治疗方案,应用XELOX加BV治疗10个疗程。二线治疗采用IRIS治疗6个疗程。然而,这未能阻止他病情进展。作为三线治疗,应用帕尼单抗治疗2个疗程,观察到肝转移灶大小显著缩小。我们的研究结果表明,帕尼单抗在有效治疗不可切除的IV期结直肠癌患者方面具有巨大潜力。