A case of local advanced colorectal cancer, for which radical surgery is difficult, responding well to neoadjuvant chemotherapy(sox+bevacizumab)and subsequently resected surgically.

今回われわれはSOX+Bev. による術前化学療法が奏効し,切除可能となった多臓器浸潤の局所進行大腸癌の1例を経験した.症例は60歳代男性でS状結腸癌が膀胱および腹壁へ浸潤して一塊の腫瘤を形成していた.イレウス症状はなかったためSOX+Bev. を4コース投与した.術前化学療法により著明に腫瘍は縮小しRECIST(Ver.1.1)基準でPRと判定された腫瘤とともに膀胱全摘術,両側尿管皮膚瘻造設術を施行した.比較的安全に骨盤内手術操作が可能であり,癌の断端遺残のない手術を行うことができた.分子標的治療薬を含む術前化学療法を行うことで手術による根治率の向上が期待できるものの,今後さらなる症例の集積が必要であり,再発率や全生存期間などを含め詳細なる検討が必要であると考えられた.

We present a surgical case of locally advanced colorectal cancer after neoadjuvant chemotherapy. The case was a man in him 60s, he had sigmoid colon cancer. The tumor was large mass and spread from the urinary bladder to abdominal wall. He had few symptom of ileus, so we performd neoadjuvant chemotherapy with S-1 and oxaliplatin(SOX)plus Bevacizumab for four cycles to him.After neoadjuvant chemotherapy, objective tumor shrinkage was observed with this case, and treatment resulted in a partial response by Response Evaluation Criteria in Solid Tumors(RECIST).The case was underwent safety surgery with no residual margin.In conclusion, neoadjuvant chemotherapy with SOX or mFOLFOX6+ B-mab may safe and improve surgical rate with no residual margin. Further studies on neoadjuvant chemotherapy for locally advanced colorectal cancer will be need about survival data such as PFS and OS.

局所進行大腸癌

術前化学療法

Bevacizumab

SOX

mFOLFOX