内容紹介
A Case of Long-Term Survival after Peritoneal Recurrence of Rectal Cancer Achieved by Tumorectomy and Adjuvant Chemotherapy
Summary
The patient was a 40-year-old woman. She began experiencing abdominal pain and constipation in July 2005. She underwent endoscopy in August, which revealed rectal cancer. She was referred to our hospital for surgery and underwent anterior resection with lymph node dissection in September. The pathological diagnosis was tub2, SS, N2, ly1, v1, stage Ⅲb. After discharge, she began oral chemotherapy. However, in April 2006, computed tomography(CT)revealed recurrence in the Douglas pouch. She began FOLFOX4 treatment in May. On follow-up CT performed in July, the recurrent sites were limited to 2 nodules and were deemed resectable. The patient underwent peritoneal dissemination resection, and the pathological diagnosis was metastatic tumor. She subsequently received 11 postoperative FOLFOX4 courses. The chemotherapy regimen was changed to the de Gramont regimen because of peripheral neuropathy. After 56 courses of the de Gramont regimen, the chemotherapy regimen was further changed to UFT/UZEL. The patient received 28 additional courses but experienced hair loss and requested treatment cessation. To date, she remains alive without recurrence.
要旨
症例は40歳,女性。2005年7月より腹痛,便秘症状が出現。内視鏡検査でRs直腸癌と診断され,当院で前方切除郭清(D3)を施行した。病理診断はtub2,SS,N2,ly1,v1,stage Ⅲbであり,R0・Cur A手術であった。退院後外来で内服化学療法を行っていたが,2006年4月のCTでDouglas窩に再発を認めたためFOLFOX4を開始し,6月のCTで画像上2個の結節に限局しており,切除可能と判断して腹膜播種切除術を施行した。病理では転移性と診断された。その後 FOLFOX4 を再開し,計11コース施行した。痺れが強く,継続が困難となり,de Gramontに変更し56コース施行した。その後UFT/UZELに変更し,28コース施行したが,脱毛が強く,本人の希望で中止した。その後も再発などなく,現在まで8年5か月無再発生存中である。
目次
Summary
The patient was a 40-year-old woman. She began experiencing abdominal pain and constipation in July 2005. She underwent endoscopy in August, which revealed rectal cancer. She was referred to our hospital for surgery and underwent anterior resection with lymph node dissection in September. The pathological diagnosis was tub2, SS, N2, ly1, v1, stage Ⅲb. After discharge, she began oral chemotherapy. However, in April 2006, computed tomography(CT)revealed recurrence in the Douglas pouch. She began FOLFOX4 treatment in May. On follow-up CT performed in July, the recurrent sites were limited to 2 nodules and were deemed resectable. The patient underwent peritoneal dissemination resection, and the pathological diagnosis was metastatic tumor. She subsequently received 11 postoperative FOLFOX4 courses. The chemotherapy regimen was changed to the de Gramont regimen because of peripheral neuropathy. After 56 courses of the de Gramont regimen, the chemotherapy regimen was further changed to UFT/UZEL. The patient received 28 additional courses but experienced hair loss and requested treatment cessation. To date, she remains alive without recurrence.
要旨
症例は40歳,女性。2005年7月より腹痛,便秘症状が出現。内視鏡検査でRs直腸癌と診断され,当院で前方切除郭清(D3)を施行した。病理診断はtub2,SS,N2,ly1,v1,stage Ⅲbであり,R0・Cur A手術であった。退院後外来で内服化学療法を行っていたが,2006年4月のCTでDouglas窩に再発を認めたためFOLFOX4を開始し,6月のCTで画像上2個の結節に限局しており,切除可能と判断して腹膜播種切除術を施行した。病理では転移性と診断された。その後 FOLFOX4 を再開し,計11コース施行した。痺れが強く,継続が困難となり,de Gramontに変更し56コース施行した。その後UFT/UZELに変更し,28コース施行したが,脱毛が強く,本人の希望で中止した。その後も再発などなく,現在まで8年5か月無再発生存中である。