内容紹介
Preoperative Chemotherapy with Modified FOLFOX+Panitumumab for the Treatment of Descending Colon Cancer with Multiple Liver Metastases―A Case Study
Summary
A 40-year-old woman visited her primary care physician because she had pain in the upper right part of the abdomen. She was diagnosed with descending colon cancer with multiple liver metastases, and was referred to our department. After a laparoscopic abdominal colectomy for removal of the original lesion, chemotherapy was initiated with a modified combination of folinic acid, 5-fluorouracil, and oxaliplatin(mFOLFOX6)+panitumumab. After 12 courses of treatment with the mFOLFOX6+panitumumab combination, followed by 13 courses of the simplified biweekly 5-fluorouracil and Leucovorin(sLV5FU2)+panitumumab combination, her liver tumors had regressed to about 90% of their original size. A laparoscopic partial hepatectomy was successfully performed. Histopathological examination indicated a Grade 2 regression of the tumor in response to chemotherapy. This report highlights the effectiveness of“conversion therapy”after chemotherapy with the mFOLFOX6+panitumumab combination, especially in those patients with multiple liver metastases from colorectal cancer.
要旨
症例は40歳,女性。右上腹部痛を主訴に発症した下行結腸癌で,生検の結果は高分化型腺癌,K-ras遺伝子は野生型であった。CTでは肝両葉に多発する腫瘤を認め,多発肝転移を伴う高度進行大腸癌と診断された。原発巣切除を先行する方針とし,腹腔鏡補助下結腸部分切除術を施行した。その後,mFOLFOX6+パニツムマブ療法12コース,sLV5FU2+パニツムマブ療法13コース施行し,CT,MRI上肝転移は肝S5の腫瘤を残すのみとなった。残存した腫瘍は切除可能と判断し,腹腔鏡下肝部分切除術を施行した。多発肝転移を伴った下行結腸癌に対しパニツムマブ+mFOLFOX6療法が奏効し,H3であるにもかかわらずconversion therapyが可能となった1例を経験したので報告する。
目次
Summary
A 40-year-old woman visited her primary care physician because she had pain in the upper right part of the abdomen. She was diagnosed with descending colon cancer with multiple liver metastases, and was referred to our department. After a laparoscopic abdominal colectomy for removal of the original lesion, chemotherapy was initiated with a modified combination of folinic acid, 5-fluorouracil, and oxaliplatin(mFOLFOX6)+panitumumab. After 12 courses of treatment with the mFOLFOX6+panitumumab combination, followed by 13 courses of the simplified biweekly 5-fluorouracil and Leucovorin(sLV5FU2)+panitumumab combination, her liver tumors had regressed to about 90% of their original size. A laparoscopic partial hepatectomy was successfully performed. Histopathological examination indicated a Grade 2 regression of the tumor in response to chemotherapy. This report highlights the effectiveness of“conversion therapy”after chemotherapy with the mFOLFOX6+panitumumab combination, especially in those patients with multiple liver metastases from colorectal cancer.
要旨
症例は40歳,女性。右上腹部痛を主訴に発症した下行結腸癌で,生検の結果は高分化型腺癌,K-ras遺伝子は野生型であった。CTでは肝両葉に多発する腫瘤を認め,多発肝転移を伴う高度進行大腸癌と診断された。原発巣切除を先行する方針とし,腹腔鏡補助下結腸部分切除術を施行した。その後,mFOLFOX6+パニツムマブ療法12コース,sLV5FU2+パニツムマブ療法13コース施行し,CT,MRI上肝転移は肝S5の腫瘤を残すのみとなった。残存した腫瘍は切除可能と判断し,腹腔鏡下肝部分切除術を施行した。多発肝転移を伴った下行結腸癌に対しパニツムマブ+mFOLFOX6療法が奏効し,H3であるにもかかわらずconversion therapyが可能となった1例を経験したので報告する。