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Abstract
A 72-year-old woman was diagnosed with Borrmann type I and II tumors in the rectosigmoid colon by colonoscopy. Whole-body Computed Tomography (CT) revealed two 1-cm masses on both lungs; however, no mass was observed in the liver. The patient underwent low anterior resection for the treatment of colorectal cancer. One month after surgery, her serum Carcinogenic Embryonic Antigen levels had doubled (283 ng/mL) compared with that at surgery; therefore, contrast-enhanced CT revealed liver metastatic lesions at segments 2 and 5. For her advanced colorectal cancer with lung and liver metastases, five cycles of chemotherapy consisting of infusional irinotecan, l-LV, and a bolus injection of 5-FU on day 1 followed by oral UFT and LV on days 1-7 were continued until the patient could not endure the adverse effects in the gastrointestinal tract. This regimen was chosen with the intention of reducing the infusional administration of drugs. Subsequently, an oral regimen of UFT/LV was initiated at the outpatient clinic. Twelve months later, CT revealed the disappearance of lung and liver lesions, and her serum CEA levels had returned to normal; therefore, the patient was considered to exhibit a Complete Response (CR). The chemotherapy was subsequently discontinued at the patient’s request and she has maintained CR for over a year.
Highlights
IntroductionThe combination of 5-FU, CPT11, and oxaliplatin (termed as FOLFOX or FOLFIRI therapy) with the additional use of bevacizumab, is recommended as a standard therapy
For advanced colorectal cancer, the combination of 5-FU, CPT11, and oxaliplatin with the additional use of bevacizumab, is recommended as a standard therapy
5-FU monotherapy is recommended in the treatment of relatively slowly progressing advanced colorectal cancer, which is equivalent to group 3 of colorectal cancer according to the ESMO guidelines [1]
Summary
The combination of 5-FU, CPT11, and oxaliplatin (termed as FOLFOX or FOLFIRI therapy) with the additional use of bevacizumab, is recommended as a standard therapy. We report a case of complete response after treatment with prolonged UFT/LV regimen for liver and lung metastases of rectal cancer. Thereafter, in April 2008, CT revealed the disappearance of bilateral metastatic lesions in the lungs and in segment 1 of the liver along with a reduced lesion size in segments 5 and 7 (Figure 3c). Serum CEA levels had returned to normal (2.8 ng/mL) At this time, we recommended resection of the metastatic lesions of the liver and lung, but the patient did not consent to surgical treatment. In June 2012, follow-up CT revealed no metastatic lesions in the lungs and liver (Figure 3e). We believed that the blood concentration of 5-FU may increase in association with a metabolic abnormality of dihydropyrimidine dehydrogenase (DPD); we measured the blood concentration of 5-FU before and after its administration but found levels within the normal range (Figure 5)
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