Tokuhara Katsuji, Satake Ryosuke, Ueyama Yosuke, Yamamichi Keigo, Sekimoto Mitsugu
Dept. of Gastroenterological Surgery, Kansai Medical University Medical Center.
Gan To Kagaku Ryoho. 2021 Nov;48(11):1405-1407.
We have introduced neoadjuvant chemotherapy(NAC)for locally advanced lower rectal cancer(LARC)since 2014. We report 2 LARC cases in which a pathological complete response(pCR)was obtained by using cetuximab(Cmab)plus oxaliplatin plus S-1(SOX)for NAC. Case 1: A 68-year-old woman underwent 4 courses of Cmab plus SOX for Rb rectal cancer (well-differentiated adenocarcinoma, cStage Ⅲc: cT4b[vagina]N3M0). Lap posterior pelvic exenteration was performed. The pathological findings of the resected specimen revealed no carcinoma and we diagnosed it as pCR. As of 31 months after the operation, she is alive without recurrence. Case 2: A 72-year-old man underwent 4 courses of Cmab plus SOX for middle and lower rectal cancer(Rab, moderately differentiated tubular adenocarcinoma, cStage Ⅲc: cT3N3M0). After NAC, with the diagnosis of ycT3N0M0, laparoscopic-assisted(Lap)super-low anterior resection with bilateral lateral pelvic node dissection was performed. The pathological findings of the resected specimen revealed no carcinoma and we diagnosed it as pCR. As of 37 months after the operation, he is alive without recurrence. NAC with Cmab plus SOX may be an effective treatment for LARC.
自2014年以来,我们已将新辅助化疗(NAC)引入局部晚期低位直肠癌(LARC)的治疗。我们报告2例LARC病例,通过使用西妥昔单抗(Cmab)联合奥沙利铂加S-1(SOX)进行NAC获得了病理完全缓解(pCR)。病例1:一名68岁女性因Rb期直肠癌(高分化腺癌,cⅢc期:cT4b[阴道]N3M0)接受了4个疗程的Cmab联合SOX治疗。进行了腹腔镜后盆腔脏器清除术。切除标本的病理检查结果显示无癌,我们将其诊断为pCR。截至术后31个月,她仍存活且无复发。病例2:一名72岁男性因中低位直肠癌(Rab,中分化管状腺癌,cⅢc期:cT3N3M0)接受了4个疗程的Cmab联合SOX治疗。NAC后,诊断为ycT3N0M0,进行了腹腔镜辅助(Lap)超低位前切除术并双侧盆腔淋巴结清扫。切除标本的病理检查结果显示无癌,我们将其诊断为pCR。截至术后37个月,他仍存活且无复发。Cmab联合SOX的NAC可能是LARC的一种有效治疗方法。