Takahashi Hidenori, Ishikawa Toshiaki, Iwata Noriko, Baba Hironobu, Masuda Taiki, Okazaki Satoshi, Matsuyama Takatoshi, Ishiguro Megumi, Kobayashi Hirotoshi, Iida Satoru, Uetake Hiroyuki, Sugihara Kenichi
Dept. of Surgical Oncology, Tokyo Medical and Dental University.
Gan To Kagaku Ryoho. 2013 Nov;40(12):1953-5.
A 58-year-old woman had a very large advanced rectal cancer( with wild-type K-RAS expression). Abdominal computed tomography( CT) revealed a space-occupying lesion in the pelvis and an enlarged lymph node. We established a diagnosis of unresectable rectal cancer and subsequently performed transverse colostomy. The patient received 6 courses of Leucovorin, fluorouracil, and oxaliplatin( mFOLFOX6) plus panitumumab( Pmab), 2 courses of simplified Leucovorin plus 5-fluorouraci(l sLV5-FU) plus Pmab, and 1 course of Pmab. The size of the primary tumor decreased remarkably after chemotherapy. Low anterior resection was performed. The pathological stage was T4a, N0, M1, Stage IVa. The results from this case suggest that mFOLFOX6 plus Pmab preoperative chemotherapy is a useful regimen for the treatment of locally advanced K-RAS wild-type rectal cancer.
一名58岁女性患有非常大的晚期直肠癌(K-RAS表达野生型)。腹部计算机断层扫描(CT)显示盆腔有占位性病变和一个肿大的淋巴结。我们诊断为不可切除的直肠癌,随后进行了横结肠造口术。患者接受了6个疗程的亚叶酸钙、氟尿嘧啶和奥沙利铂(mFOLFOX6)加帕尼单抗(Pmab),2个疗程的简化亚叶酸钙加5-氟尿嘧啶(sLV5-FU)加Pmab,以及1个疗程的Pmab。化疗后原发肿瘤大小显著减小。进行了低位前切除术。病理分期为T4a,N0,M1,IVa期。该病例结果表明,mFOLFOX6加Pmab术前化疗是治疗局部晚期K-RAS野生型直肠癌的有效方案。