Hayashi M, Shirai Y, Hatakeyama K
Department of Surgery, Niigata University School of Medicine, Japan.
Hepatogastroenterology. 1997 Nov-Dec;44(18):1612-3.
Although the efficacy of radiotherapy for the palliation of recurrent or inoperable cancer has been proven, it results in complete tumor remission only rarely. We report a case of pelvic recurrence in which complete histological remission followed radiotherapy. A 68-year-old man developed a small pelvic recurrence near the rectal stump 8 months after a Hartmann procedure for rectal cancer. Histologic examination of the biopsy specimens revealed adenocarcinoma consistent with the primary tumor. He received radiotherapy to the whole pelvis, with a total dose of 39.4 Gy administered in 22 fractions over 4 weeks, with a continuous infusion of 5-fluorouracil as a radiosensitizer. After regression of the tumor was confirmed, resection of the pelvic recurrence was performed. Histologic examination of the resected specimen revealed no tumor. Thirty-six months after the second operation, the patient was alive with no evidence of disease. The experience of our case and a review of the literature suggests that small pelvic recurrences may be more responsive to radiotherapy than larger ones.
尽管放射疗法对复发性或无法手术的癌症进行姑息治疗的疗效已得到证实，但它仅很少能使肿瘤完全缓解。我们报告一例盆腔复发病例，放疗后实现了组织学完全缓解。一名68岁男性在直肠癌Hartmann手术后8个月，直肠残端附近出现盆腔小复发灶。活检标本的组织学检查显示腺癌与原发肿瘤一致。他接受了全盆腔放疗，在4周内分22次给予总剂量39.4 Gy，并持续输注5-氟尿嘧啶作为放射增敏剂。在确认肿瘤消退后，对盆腔复发灶进行了切除。切除标本的组织学检查未发现肿瘤。第二次手术后36个月，患者存活且无疾病证据。我们的病例经验及文献回顾表明，盆腔小复发灶可能比大复发灶对放疗更敏感。
