Motoki Yoshiyuki, Sugimoto Keishi, Sakisaka Hideki, Nakano Katsutoshi, Kan Kazuomi, Nakaguchi Kazunori, Doi Sadayuki
Dept. of Surgery, Kawanishi City Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(13):2357-2359.
A 62-year-old man with diarrhea and metastases was found to harbor 2 rectal cancers. Both lateral lymph nodes were suspected based on CT and PET-CT(cT3N3M0, cStage Ⅲb). We planned to administer neoadjuvant chemotherapy(NAC) (CapeOX plus Bmab). After 4 courses of NAC, the sizes of both the primary tumor and lymph nodes decreased(partial response: PR). We performed laparoscopic abdominoperineal resection of the rectum(APR)with dissection of both lateral lymph nodes. The therapeutic effect was PR(few residual cancer cells)(Grade 2). After 4 courses of adjuvant chemotherapy (CapeOX), there have been no signs of recurrence for 8 months. This case suggests that laparoscopic APR after NAC with CapeOX plus Bmab for locally advanced rectal cancer is a potentially effective procedure.
一名62岁腹泻伴转移的男性被发现患有2处直肠癌。基于CT和PET-CT检查怀疑双侧淋巴结受累（cT3N3M0，cⅢb期）。我们计划给予新辅助化疗（NAC）（奥沙利铂联合贝伐单抗）。4个疗程的NAC治疗后，原发肿瘤和淋巴结大小均减小（部分缓解：PR）。我们实施了腹腔镜腹会阴联合直肠癌根治术（APR）并清扫双侧淋巴结。治疗效果为PR（残留癌细胞极少）（2级）。4个疗程的辅助化疗（奥沙利铂）后，8个月来无复发迹象。该病例提示，对于局部进展期直肠癌，NAC联合奥沙利铂及贝伐单抗治疗后行腹腔镜APR是一种潜在有效的治疗方法。
