内容紹介
A Case Study of Stable Disease after Hepatic Arterial Infusion Chemotherapy in a Patient with Systemic Chemotherapy-Resistant Unresectable Hepatic Metastases of Colon Cancer
Summary
The patient was a 72-year-old man with cancer of the descending colon accompanied by multiple unresectable hepatic metastases. As first-line systemic chemotherapy, mFOLFOX6, anti-vascular endothelial growth factor(VEGF)antibody+FOLFIRI, and anti-epidermal growth factor receptor(EGFR)antibody+CPT-11 were administered in order mentioned. However, recurrent hepatic metastasis was exacerbated. As fourth-line chemotherapy, the patient received hepatic arterial infusion chemotherapy(HAIC)with 5-FU and LV. The chemotherapy regimen consisted of 5-FU 600 mg/m2 and LV 250 mg/m2 given once a week. After 6 weeks, CT revealed that the multiple liver metastases had not increased, and the level of the tumor marker CA19-9 significantly decreased from 1,980(normal range, 0-37 U/mL)to 942.9 U/mL. HAIC was continued, and the patient maintained an excellent PS for 3.5 months. We report a case of stable disease in response to HAIC in a patient who exhibited resistance to systemic chemotherapy with an anti-EGFR antibody, an anti-EGFR antibody, mFOLFOX6, and FOLFIRI.
要旨
症例は72歳,男性。下行結腸癌,切除不能肝転移に対し,左半結腸切除術(D3),ならびに肝転移巣には全身化学療法: mFOLFOX6,抗anti-vascular endothelial growth factor(VEGF)抗体+FOLFIRI,抗anti-epidermal growth factor receptor(EGFR)抗体+CPT-11を順に施行した。全身化学療法は有効性を示したが,最終的に薬剤耐性を示し肝転移巣が増悪する結果となった。インフォームド・コンセントの後,5-FU,LVによる肝動注化学療法施行したところ,6回終了後には腫瘍マーカーは著明に低下し,現在12回終了(肝動注療法開始後3.5か月経過)しているが,腫瘍マーカーは横ばい状態でCT画像においても腫瘍の増大は抑えられ,SD状態を保っている。また,performance statusは良好で新病変の出現もなく,外来化学療法を継続している。今回,全身化学療法による分子標的薬,mFOLFOX6,FOLFIRI治療に抵抗性を示した切除不能大腸癌肝転移巣に肝動注療法が有効であった症例を報告する。
目次
Summary
The patient was a 72-year-old man with cancer of the descending colon accompanied by multiple unresectable hepatic metastases. As first-line systemic chemotherapy, mFOLFOX6, anti-vascular endothelial growth factor(VEGF)antibody+FOLFIRI, and anti-epidermal growth factor receptor(EGFR)antibody+CPT-11 were administered in order mentioned. However, recurrent hepatic metastasis was exacerbated. As fourth-line chemotherapy, the patient received hepatic arterial infusion chemotherapy(HAIC)with 5-FU and LV. The chemotherapy regimen consisted of 5-FU 600 mg/m2 and LV 250 mg/m2 given once a week. After 6 weeks, CT revealed that the multiple liver metastases had not increased, and the level of the tumor marker CA19-9 significantly decreased from 1,980(normal range, 0-37 U/mL)to 942.9 U/mL. HAIC was continued, and the patient maintained an excellent PS for 3.5 months. We report a case of stable disease in response to HAIC in a patient who exhibited resistance to systemic chemotherapy with an anti-EGFR antibody, an anti-EGFR antibody, mFOLFOX6, and FOLFIRI.
要旨
症例は72歳,男性。下行結腸癌,切除不能肝転移に対し,左半結腸切除術(D3),ならびに肝転移巣には全身化学療法: mFOLFOX6,抗anti-vascular endothelial growth factor(VEGF)抗体+FOLFIRI,抗anti-epidermal growth factor receptor(EGFR)抗体+CPT-11を順に施行した。全身化学療法は有効性を示したが,最終的に薬剤耐性を示し肝転移巣が増悪する結果となった。インフォームド・コンセントの後,5-FU,LVによる肝動注化学療法施行したところ,6回終了後には腫瘍マーカーは著明に低下し,現在12回終了(肝動注療法開始後3.5か月経過)しているが,腫瘍マーカーは横ばい状態でCT画像においても腫瘍の増大は抑えられ,SD状態を保っている。また,performance statusは良好で新病変の出現もなく,外来化学療法を継続している。今回,全身化学療法による分子標的薬,mFOLFOX6,FOLFIRI治療に抵抗性を示した切除不能大腸癌肝転移巣に肝動注療法が有効であった症例を報告する。