title: [A case of liver metastasis of rectal cancer demonstrating complete response to 5-FU + Leucovorin + UFT].
abstract: Dihydropyrimidine dehydrogenase (DPD) is a rate-limiting enzyme that metabolizes 5-fluorouracil (5-FU). We report a patient with metachronous liver metastasis from rectal cancer with low expression of DPD, who demonstrated complete response to chemotherapy comprising 5-FU, Leucovorin, and UFT. A 53-year-old man underwent macroscopically curative proctectomy with coloanal anastomosis for lower rectal cancer (Curability B). The DPD level in the primary tumor determined by an enzyme-linked immunosorbent assay was extremely low (10.3 U/mg.protein). Three months postoperatively, 5-FU (333 mg/m2) + Leucovorin (200 mg/m2) therapy (once a week for 3 weeks with a one-week rest interval, repeatedly) was started as an adjuvant therapy. However, computed tomography demonstrated a solitary liver metastasis 3 cm in size 1 month later. Chemotherapy was continued with dose escalation of 5-FU (500 mg/m2) and with oral administration of UFT-E (400 mg/body, daily). Five months later, computed tomography did not detect the liver metastasis, and this finding was maintained for two months (complete response). This case provides evidence that a low expression of DPD in the primary lesion is related to a favorable response of liver metastasis to 5-FU-based systemic chemotherapy.
authors.affiliation: Dept. of Surgery, Saitama Medical Center, Saitama Medical School.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ishida
authors.forename: Tomonori
authors.initials: T
authors.lastname: Ohsawa
authors.forename: Ikuya
authors.initials: I
authors.lastname: Takeuchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakada
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Inokuma
authors.forename: Takanobu
authors.initials: T
authors.lastname: Hoshino
authors.forename: Hashimoto
authors.initials: H
authors.lastname: Daijo
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012074:Remission Induction; D005641:Tegafur / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; C096910:UFT(R) drug; D005641:Tegafur; D014498:Uracil; D002955:Leucovorin; D005472:Fluorouracil