Takahashi Takehiro, Namiki Kenji, Matsumoto Hiroshi, Konno Fumihiro, Mitsui Kazuhiro, Yoshida Ryuichi
Dept. of Surgery, Osaki Citizen Hospital.
Gan To Kagaku Ryoho. 2014 May;41(5):653-5.
A 51-year-old man presented with a chief complaint of constipation. Rectal cancer was detected up to 13 cm proximal to the anal verge. The cancer was a fully circumferential type II tumor that was accompanied by prostate invasion and lymph node metastasis. After sigmoid colostomy, preoperative chemoradiotherapy with S-1/irinotecan (CPT-11; total 50 Gy) was administered, resulting in tumor volume reduction. However, because of residual invasion in some parts of the prostate, therapy with capecitabine and oxaliplatin (XELOX) plus bevacizumab was added to avoid pelvic exenteration. Because magnetic resonance imaging revealed no invasion prostate after 7 courses of the therapy, abdominoperineal resection of the rectum was performed. Pathological examination revealed no residual tumor cells, and a pathological complete response was thus confirmed. The addition of chemotherapy to preoperative chemoradiotherapy was considered to be an effective strategy for locally advanced rectal cancer in this case.
一名51岁男性以便秘为主诉就诊。在距肛缘13厘米处检测到直肠癌。该癌症为完全环周型II期肿瘤，伴有前列腺侵犯和淋巴结转移。乙状结肠造口术后，给予S-1/伊立替康（CPT-11；总量50 Gy）进行术前放化疗，肿瘤体积缩小。然而，由于前列腺部分区域仍有残留侵犯，加用了卡培他滨和奥沙利铂（XELOX）联合贝伐单抗治疗以避免盆腔脏器清除术。由于7个疗程治疗后磁共振成像显示无前列腺侵犯，遂行腹会阴联合直肠癌切除术。病理检查未发现残留肿瘤细胞，因此证实为病理完全缓解。在该病例中，术前放化疗联合化疗被认为是局部晚期直肠癌的有效治疗策略。
