Kanto Satoshi, Takeji Satoru, Okamura Miru, Sakikubo Morito, Tatsumi Kentarou, Yasuda Seiichi, Kawabe Atsushi
Dept. of Gastrointestinal Surgery, Hikone Municipal Hospital.
Gan To Kagaku Ryoho. 2020 Oct;47(10):1517-1520.
A 66-year-old male diagnosed with transverse colon cancer was admitted to our hospital. Computed tomography, colonoscopy, and esophagogastroduodenoscopy revealed locally advanced cancer with invasion of the gastric antrum. We staged the disease as cT4a, cN2, cM0, Stage ⅢB, with wild-type RAS expression. We performed an ileostomy prior to administering chemotherapy. The patient received 4 courses of modified FOLFOXIRI plus bevacizumab and 2 courses of FOLFIRI. The size of the tumor noticeably decreased after chemotherapy. The patient experienced grade 3 neutropenia, anorexia, and oral mucositis during chemotherapy. We performed a right hemicolectomy(D3), partial gastrectomy and ileum resection after administering neoadjuvant chemotherapy. The pathological stage of the disease was ypT2, ypN0, ypM0, ypStageⅠ, and the effect of the chemotherapy was Grade 1b. After the resection, he received mFOLFOX6 and CapeOX for 3 months as adjuvant chemotherapy. He remained cancer-free for 1 year and 3 months after the surgery. This result suggests that preoperative modified FOLFOXIRI plus bevacizumab chemotherapy is a useful regimen for the treatment of locally advanced colon cancer.
一名66岁被诊断为横结肠癌的男性患者入住我院。计算机断层扫描、结肠镜检查和食管胃十二指肠镜检查显示为局部进展期癌症,侵犯胃窦。我们将该疾病分期为cT4a、cN2、cM0,ⅢB期,RAS表达为野生型。在进行化疗之前,我们实施了回肠造口术。该患者接受了4个疗程的改良FOLFOXIRI加贝伐单抗治疗以及2个疗程的FOLFIRI治疗。化疗后肿瘤大小明显缩小。该患者在化疗期间出现了3级中性粒细胞减少、厌食和口腔黏膜炎。在给予新辅助化疗后,我们实施了右半结肠切除术(D3)、部分胃切除术和回肠切除术。该疾病的病理分期为ypT2、ypN0、ypM0,ypⅠ期,化疗效果为1b级。切除术后,他接受了3个月的mFOLFOX6和CapeOX辅助化疗。术后他无癌生存1年零3个月。这一结果表明,术前改良FOLFOXIRI加贝伐单抗化疗是治疗局部进展期结肠癌的一种有效方案。