Nemoto Tetsutaro, Endo Shungo, Isohata Noriyuki, Takayanagi Daisuke, Nemoto Daiki, Aizawa Masato, Utano Kenichi, Togashi Kazutomo, Oshibe Ikuro, Soeta Nobutoshi, Saito Takuro
Dept. of Coloproctology, Aizu Medical Center, Fukushima Medical University.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2410-2412.
We report 2 cases of advanced colorectal cancer achieving complete response by FOLFOXIRI plus bevacizumab. Case 1 was a 65-year-old male diagnosed with descending colon cancer with multiple liver metastases. Six courses of FOLFOXIRI plus bevacizumab were administered after laparoscopic-assisted left hemicolectomy. Ten partial hepatectomies and 1 radiofrequency ablation were performed as the liver metastases resolved. A pathological complete response was confirmed. Adjuvant chemotherapy was not administered, and recurrence-free survival was 21 months after hepatectomy. Case 2 was a 77-yearold male diagnosed with rectal cancer invading the pelvic wall and sacral foramen with bilateral lateral lymph node metastasis. Additionally, there was a cancer embolism in the right internal iliac vein. Six courses of FOLFOXIRI plus bevacizumab were administered, and the cancer tissue was absent on subsequent CT and MRI. The cancer was scarred by colonoscopy, and the biopsy showed no malignant cells. Six courses of FOLFIRI plus panitumumab were administered as second-line chemotherapy, and the patient survived without any recurrence after 12 months from initiation of chemotherapy.
我们报告了2例晚期结直肠癌患者通过FOLFOXIRI联合贝伐单抗治疗获得完全缓解的病例。病例1为一名65岁男性,诊断为降结肠癌伴多发肝转移。在腹腔镜辅助下左半结肠切除术后给予6个疗程的FOLFOXIRI联合贝伐单抗治疗。随着肝转移灶的消退,进行了10次部分肝切除术和1次射频消融术。确认达到病理完全缓解。未给予辅助化疗,肝切除术后无复发生存期为21个月。病例2为一名77岁男性,诊断为直肠癌侵犯盆腔壁和骶孔伴双侧侧方淋巴结转移。此外,右侧髂内静脉有癌栓形成。给予6个疗程的FOLFOXIRI联合贝伐单抗治疗,随后的CT和MRI检查显示癌组织消失。结肠镜检查显示癌组织呈瘢痕样改变,活检未发现恶性细胞。给予6个疗程的FOLFIRI联合帕尼单抗作为二线化疗,患者自化疗开始12个月后无任何复发存活。