Irinotecan局所動注化学療法と5‐FU,leucovorinの全身投与が奏効した直腸癌骨盤内再発の1例  [in Japanese] A CASE OF INTRAPELVIC RECURRENCE OF RECTAL CANCER TREATED WITH INTRAARTERIAL INFUSION CHEMOTHERAPY WITH IRINOTECAN AND SYSTEMIC MEDICATION OF 5-FU AND LEUCOVORIN  [in Japanese]

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Abstract

進行直腸癌術後の局所再発は切除不能な場合も多く,疼痛などQOLの面でも治療に難渋することが多い.今回われわれは,直腸癌術後局所再発の症例に対しCPT-11の局所動注化学療法施行により有効な治療効果を得られた症例を経験したので報告する.症例は55歳,男性. H14年5月,骨盤内局所,リンパ節再発,膀胱直接浸潤指摘.手術施行は困難と判断し, CPT-11局所動注化学療法balloon occluded arterial injection (BOAI)施行した. (方法)左右内腸骨動脈よりCPT-11計40mg/m<sup>2</sup>を投与. 1週間の休薬後5-FU (370mg/m<sup>2</sup>/5day)+LV (20mg/m<sup>2</sup>/5day)にて全身化学療法施行後2週休薬.これを1クールとした. (結果) 1クール施行後よりCT上膀胱直接浸潤した腫瘤は著明に縮小した.治療を断念せざるを得ない副作用の出現もなかった.本法はone-shotの動注療法であり,リザーバーが挿入可能であれば外来治療ができ, QOL改善に有効であると考えられた.

Local recurrence after surgery for advanced rectal cancer is often unresectable and we have a great deal of difficulty in the treatment of symptoms such as pain. This paper presents a case of intrapelvic recurrence after an operation for rectal cancer, in which intraarterial chemotherapy with CPT-11 and systemic chemotherapy with 5-FU and LV were very effective. A 55-year-old man had intrapelvic recurrence, lymph node metastasis, and direct invasion into the bladder in May 2002. We thought that surgery was impossible and gave balloon occluded arterial injection (BOAI) with CPT-11 to the patient. A total of 40mg/m<sup>2</sup> of CPT-11 was injected to the bilateral iliac arteries. After an one-week withdrawal, systemic chemotherapy with 5-FU (370mg/m<sup>2</sup> for 5days) + LV (20mg/m<sup>2</sup> for 5days) was conducted with 2-week withdrawal. After this regimen (one course), the tumor invading the bladder remarkably diminished. No adverse side effects which might withdraw the regimen occurred. This regimen is one-shot intraarterial therapy so that it can be given in the outpatient clinic if a reservoir can be inserted, and greatly contributes to improve the patient's QOL.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 64(7), 1714-1719, 2003

    Japan Surgical Association

Keywords

Codes

  • NII Article ID (NAID)
    130003432726
  • Text Lang
    JPN
  • ISSN
    1345-2843
  • Data Source
    J-STAGE 
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