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[1例横结肠癌伴肝转移及门静脉瘤栓经化疗有效治疗的病例]

[A Case of Transverse Colon Cancer with Liver Metastasis and Tumor Thrombosis of Portal Vein Effectively Treated with Chemotherapy].

作者信息

Aida Toshiaki, Shiobara Masayuki, Wakatsuki Kazuo, Arai Shuka, Suda Kosuke, Miyazawa Kotaro, Miyoshi Tetsutaro, Takahashi Yoshihisa, Yoshioka Shigeru

机构信息

Dept. of Surgery, Chiba Kaihin Municipal Hospital.

出版信息

Gan To Kagaku Ryoho. 2018 Feb;45(2):374-376.

Abstract

The patient was a 70-year-old man. He was diagnosed with advanced transverse colon cancer. A computed tomography (CT)revealed liver metastasis and tumor thrombosis of portal vein. We started combination chemotherapy with capecita- bine/oxaliplatin(CapeOX). Perforation of the tumor was observed 5 days after CapeOX therapy was started. Treatment with abscess drainage and ileostmy, infection was controlled and general condition was improved. After 9 courses of CapeOX, we changed chemotherapy regimen to irinotecan/tegafur-gimeracil-oteracilpotassium (IRIS)due to strong side effects. In CT and FDG-PET examination after 8 courses of IRIS, the tumor of transverse colon, liver metastasis, and the tumor thrombosis of portalvein became unclear. A year and 6 months have passed since chemotherapy was started, recurrence was not observed. For the patients with unresectable colorectal cancer, it is necessary to consider multidisciplinary treatments including chemotherapy while considering the general condition of them.

摘要

该患者为一名70岁男性。他被诊断为晚期横结肠癌。计算机断层扫描(CT)显示有肝转移和门静脉肿瘤血栓形成。我们开始使用卡培他滨/奥沙利铂(CapeOX)进行联合化疗。在开始CapeOX治疗5天后观察到肿瘤穿孔。通过脓肿引流和回肠造口术进行治疗,感染得到控制,一般状况有所改善。在进行9个疗程的CapeOX治疗后,由于强烈的副作用,我们将化疗方案改为伊立替康/替吉奥(IRIS)。在进行8个疗程的IRIS治疗后的CT和氟脱氧葡萄糖正电子发射断层显像(FDG-PET)检查中,横结肠肿瘤、肝转移灶和门静脉肿瘤血栓变得不清晰。自开始化疗以来已过去一年零六个月,未观察到复发情况。对于无法切除的结直肠癌患者,在考虑其一般状况的同时,有必要考虑包括化疗在内的多学科治疗。

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