術前化学療法を行った局所進行大腸癌の6例  [in Japanese] Six Cases Treated with a New Neoadjuvant Chemotherapy without Radiotherapy for Locally Advanced Colorectal Cancer  [in Japanese]

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Abstract

局所進行大腸癌(直腸癌5例,S状結腸癌1例)に対し,mFOLFOX6療法あるいはSOX療法にbevacizumabを併用した新規術前化学療法を行った.術前放射線療法は併用しなかった.6例全例で良好な腫瘍縮小効果が得られ,骨盤腔内での手術操作が容易となった.膀胱浸潤例を除く6例中5例にR0切除が施行され,その5例に局所再発を認めなかった.また,pCRあるいはnear-pCRを6例中2例に認めた.術前化学療法中の有害事象としてGrade3の好中球減少症を3例に,肝機能障害を1例に認め,術後合併症として縫合不全を1例に認めた.放射線療法を併用しない新規術前化学療法は局所進行大腸癌に対する有力な一つの治療オプションになり得ると考えられた.

Six patients with locally advanced colorectal cancer (including 5 cases of rectal cancer and 1 case of sigmoid colon cancer) were treated with a new neoadjuvant chemotherapy using either mFOLFOX6 plus bevacizumab, or SOX plus bevacizumab. No preoperative radiotherapy was applied in any of the cases. All six patients showed good tumor regression, which facilitated tumor resection in the limited pelvic space. Of the 6 patients, R0 resection was accomplished successfully with no local relapse in 5 patients, while the sixth patient developed invasion of the urinary bladder. Furthermore, 2 patients showed a pathological complete response (pCR) or near-pCR. Grade 3 adverse events occurred during the chemotherapy in 3 patients, including neutropenia in 2 patients and liver dysfunction in 1 patient. Anastomotic leakage occurred in 1 patient after the surgery due to a technical error. This new neoadjuvant chemotherapy without radiotherapy appears promising as a viable treatment strategy for locally advanced colorectal cancer.

Journal

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

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 76(8), 1989-1994, 2015

    Japan Surgical Association

Codes

  • NII Article ID (NAID)
    130005128300
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • ISSN
    1345-2843
  • NDL Article ID
    030767623
  • NDL Call No.
    Z19-227
  • Data Source
    NDL  J-STAGE 
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