Takenoya Takashi, Yabe Nobushige, Kamoya Mayumi, Furuichi Satoka, Morishige Shiho, Tamura Eri, Yajima Keitaro, Iwama Nozomi, Oto Ippei, Yoshikawa Takahisa, Osumi Koji, Murai Shinji
Dept. of Surgery, Ogikubo Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):1798-1800.
An 83-year-old man visited our hospital with liver tumors detected by abdominal ultrasonography. On investigation, he was diagnosed with sigmoid colon cancer with metastasis in the supraclavicular lymph node, liver, and para-aortic lymph node(T3N1M1b, Stage ⅣB[Union for International Cancer Control 8th edition]). He was administered combination therapy with capecitabine and bevacizumab owing to the increased age and Eastern Cooperative Oncology Group performance status score of 1. After 8 courses of chemotherapy, the primary tumor and liver metastases shrank. As he developed Grade 2 hand-foot syndrome, the dose of capecitabine was decreased to 75%(1,500 mg/m2)from the 11th course and to 50% (1,000 mg/m2)from the 31st course. Until 2 years after initiation of the chemotherapy, the patient showed progression-free survival. Heparinoid-containing moisturizer and steroid ointment were administered for treatment of hand-foot syndrome. This report suggests that capecitabine plus bevacizumab therapy can maintain the quality of life and is safe with dose reduction and treatment of adverse reactions for elderly patients with colon cancer.
一名83岁男性因腹部超声检查发现肝脏肿瘤前来我院就诊。经检查,他被诊断为乙状结肠癌,伴有锁骨上淋巴结、肝脏和腹主动脉旁淋巴结转移(T3N1M1b,国际癌症控制联盟第8版ⅣB期)。由于年龄较大且东部肿瘤协作组体能状态评分为1分,他接受了卡培他滨和贝伐单抗的联合治疗。经过8个疗程的化疗后,原发肿瘤和肝转移瘤缩小。由于出现了2级手足综合征,从第11个疗程起卡培他滨剂量减至75%(1500mg/m²),从第31个疗程起减至50%(1000mg/m²)。化疗开始后2年内,患者无进展生存。使用含类肝素的保湿剂和类固醇软膏治疗手足综合征。本报告表明,卡培他滨联合贝伐单抗治疗可维持老年结肠癌患者的生活质量,通过剂量减少和不良反应治疗是安全的。