内容紹介
A Case of Rectal Cancer with Multiple Liver, Lung, and Para-Aortic Lymph Node Metastases Successfully Treated with FOLFOX4 plus Bevacizumab
Summary
A patient in his 70s was diagnosed with rectal cancer(pT3, pN1, cM0, and pStageⅢa)for which he underwent low anterior resection of the rectum and received adjuvant therapy with UFT/LV. Multiple liver, lung, and para-aortic lymph node metastases were detected after 6 months, and the patient then received a total of 24 courses of FOLFOX4 plus bevacizumab instead of UFT/LV. The liver and para-aortic lymph node metastases showed a complete response(CR), and the lung metastases markedly diminished. Therefore, the patient completed the FOLFOX4 plus bevacizumab chemotherapy regimen. After 2 years, a recurrence of the initial liver metastases was detected. A CR on radiological imaging does not correspond to a pathological CR. Therefore, a careful follow-up is required even when a CR on radiological imaging is achieved.
要旨
症例は70歳台,男性。直腸癌の診断で低位前方切除術を施行。pT3,pN1,cM0,pStageⅢaであり,術後補助化学療法はUFT+LVを施行した。術後6か月で多発性肝・肺・傍大動脈リンパ節転移を認めたため,FOLFOX4+bevacizumabに変更し合計24コース施行した。治療は奏効し画像上,肝転移巣および傍大動脈リンパ節転移巣は消失し,肺転移巣もほぼ消失したため治療を終了した。化学療法終了2年後,画像上消失していた肝転移巣が同じ場所で再発した。画像上complete response(CR)と病理学的CRは異なるため,画像上CRが得られても厳重な経過観察が必要である。
目次
Summary
A patient in his 70s was diagnosed with rectal cancer(pT3, pN1, cM0, and pStageⅢa)for which he underwent low anterior resection of the rectum and received adjuvant therapy with UFT/LV. Multiple liver, lung, and para-aortic lymph node metastases were detected after 6 months, and the patient then received a total of 24 courses of FOLFOX4 plus bevacizumab instead of UFT/LV. The liver and para-aortic lymph node metastases showed a complete response(CR), and the lung metastases markedly diminished. Therefore, the patient completed the FOLFOX4 plus bevacizumab chemotherapy regimen. After 2 years, a recurrence of the initial liver metastases was detected. A CR on radiological imaging does not correspond to a pathological CR. Therefore, a careful follow-up is required even when a CR on radiological imaging is achieved.
要旨
症例は70歳台,男性。直腸癌の診断で低位前方切除術を施行。pT3,pN1,cM0,pStageⅢaであり,術後補助化学療法はUFT+LVを施行した。術後6か月で多発性肝・肺・傍大動脈リンパ節転移を認めたため,FOLFOX4+bevacizumabに変更し合計24コース施行した。治療は奏効し画像上,肝転移巣および傍大動脈リンパ節転移巣は消失し,肺転移巣もほぼ消失したため治療を終了した。化学療法終了2年後,画像上消失していた肝転移巣が同じ場所で再発した。画像上complete response(CR)と病理学的CRは異なるため,画像上CRが得られても厳重な経過観察が必要である。