Nitori Nobuhiro, Kato Ayu, Deguchi Tomoaki, Nakadai Jumpei, Tada Ayako, Takahashi Makoto, Umeda Rumiko, Miyata Naoteru, Kataoka Mikinori, Kadomura Tomohisa, Higuchi Hajime, Ebinuma Hirotoshi, Kato Atsushi, Hatori Takashi, Ikeda Yoshifumi, Miyazaki Masaru
Center of Digestive Diseases, International University of Health and Welfare, Mita Hospital, Tokyo 108-8329, Japan.
Mol Clin Oncol. 2019 Feb;10(2):270-274. doi: 10.3892/mco.2018.1791. Epub 2018 Dec 11.
A 56-year-old man diagnosed with sigmoid colon cancer underwent sigmoid colectomy. Nine months later, his serum carcinoembryonic antigen (CEA) level had increased, and the diagnosis of recurrent peritoneal dissemination was made based on positron emission tomography/computed tomography (PET/CT) findings. Although systemic chemotherapy comprising S-1 and oxaliplatin (SOX) plus bevacizumab was initiated, severe diarrhea occurred on day 4 of the second cycle despite reduction in S-1 dose. By changing the daily oral intake schedule for S-1 to an alternate-day intake from the third cycle (modified SOX plus bevacizumab), the patient was able to continue undergoing chemotherapy without any adverse gastrointestinal effects. All tumors disappeared after four cycles, and the patients received eight cycles of modified SOX plus bevacizumab followed by maintenance chemotherapy comprising alternate-day S-1 plus bevacizumab. Maintenance chemotherapy was discontinued after 17 cycles owing to adverse events, including thrombocytopenia, corneal and lacrimal duct disorders, and hyperbilirubinemia. The patient has been radiographically confirmed to be in remission for 5 years without any recurrence, and his serum CEA level has been within normal range for >3 years. To conclude, compared with the conventional consecutive treatment, alternate-day SOX plus bevacizumab treatment may reduce the adverse effects of these chemotherapeutic drugs.
一名56岁被诊断为乙状结肠癌的男性接受了乙状结肠切除术。九个月后，他的血清癌胚抗原（CEA）水平升高，基于正电子发射断层扫描/计算机断层扫描（PET/CT）结果诊断为复发性腹膜播散。尽管开始了由S-1和奥沙利铂（SOX）加贝伐单抗组成的全身化疗，但在第二个周期的第4天出现了严重腹泻，尽管S-1剂量有所减少。从第三个周期开始将S-1的每日口服给药方案改为隔日给药（改良SOX加贝伐单抗）后，患者能够继续接受化疗且无任何胃肠道不良反应。四个周期后所有肿瘤消失，患者接受了八个周期的改良SOX加贝伐单抗治疗，随后是由隔日S-1加贝伐单抗组成的维持化疗。由于包括血小板减少、角膜和泪道疾病以及高胆红素血症在内的不良事件，17个周期后停止了维持化疗。经影像学检查证实该患者已缓解5年且无任何复发，其血清CEA水平在超过3年的时间内一直处于正常范围内。总之，与传统的连续治疗相比，隔日SOX加贝伐单抗治疗可能会降低这些化疗药物的不良反应。
