内容紹介
A Case of Rectal Cancer with Portal Vein Tumor Thrombosis Successfully Treated with First-Line Panitumumab Monotherapy
Summary
The patient was a 66-year-old man with progressive rectal cancer and portal vein tumor thrombosis near the porta hepatis. A subileus further complicated the situation. Therefore, an abdominoperineal resection was performed. As the KRAS gene was the wild-type gene, we administered panitumumab monotherapy every 2 weeks after the operation. Two months after the operation, the tumor marker levels were normal and the tumor size was reduced. Hence, oral capecitabine, with 1-week administration followed by 1-week of rest, was added to the therapy. In the 12 months after the operation, panitumumab was stopped once, and treatment with capecitabine alone was continued in the same schedule. As of 26 months, the disease showed a partial response using capecitabine alone. We report our experience of a case of rectal cancer with portal vein tumor thrombosis that was successfully treated with panitumumab.
要旨
症例は66歳,男性。肝門部に及ぶ門脈内腫瘍栓を合併した進行直腸癌であったが,サブイレウスを来していたため,腹会陰式直腸切除術を施行した。KRAS遺伝子野生型であり,術後パニツムマブ単剤にて治療を開始した。2か月後に腫瘍マーカーが正常化し腫瘍縮小効果がみられていたため,補助的にカペシタビンを併用し,12か月でパニツムマブをいったん休止した。26か月現在,カペシタビンのみを継続しPRで経過している。一般に予後不良とされる門脈内腫瘍栓に対して,パニツムマブ単剤投与が著効した1例を経験した。
目次
Summary
The patient was a 66-year-old man with progressive rectal cancer and portal vein tumor thrombosis near the porta hepatis. A subileus further complicated the situation. Therefore, an abdominoperineal resection was performed. As the KRAS gene was the wild-type gene, we administered panitumumab monotherapy every 2 weeks after the operation. Two months after the operation, the tumor marker levels were normal and the tumor size was reduced. Hence, oral capecitabine, with 1-week administration followed by 1-week of rest, was added to the therapy. In the 12 months after the operation, panitumumab was stopped once, and treatment with capecitabine alone was continued in the same schedule. As of 26 months, the disease showed a partial response using capecitabine alone. We report our experience of a case of rectal cancer with portal vein tumor thrombosis that was successfully treated with panitumumab.
要旨
症例は66歳,男性。肝門部に及ぶ門脈内腫瘍栓を合併した進行直腸癌であったが,サブイレウスを来していたため,腹会陰式直腸切除術を施行した。KRAS遺伝子野生型であり,術後パニツムマブ単剤にて治療を開始した。2か月後に腫瘍マーカーが正常化し腫瘍縮小効果がみられていたため,補助的にカペシタビンを併用し,12か月でパニツムマブをいったん休止した。26か月現在,カペシタビンのみを継続しPRで経過している。一般に予後不良とされる門脈内腫瘍栓に対して,パニツムマブ単剤投与が著効した1例を経験した。