[A case of long-term survival after chemo-radiation for postoperative local recurrence of rectal cancer].
The patient was a 64-year-old male who underwent an abdomino-perineal resection (D3) for advanced lower rectal carcinoma with a formulated vesicorectal abscess. The tumor was a well-differentiated adenocarcinoma, type 2 in the Japanese Classification of Colorectal Carcinoma, and was measured 5.5x4.3 cm in size. Histologically, the tumor was considered to be stage II (H0, P0, a2, n0 (0/86), ly0, v0). He received a postoperative chemotherapy with oral UFT-E (400 mg/day) for 1 year. After 2 years from the surgery, the patient developed a perineal pain, and pelvic CT scans revealed a 4 cm mass anterior to the sacrum. The CEA level was increased to 11 ng/ml. Consequently, a diagnosis of local recurrence was made, and radiochemotherapy was commenced. Radiotherapy was given to the pelvic region at a total dose of 70 Gy (Given 2 Gy each x 35 fragments). Chemotherapy with CDDP and 5-FU was administered via the right internal iliac artery followed by administration of 5'-DFUR (600 mg/day). After that regimen, a recurrence of the pelvic tumor caused an increase in pain, and the patient developed renal failure. He died after 4 years and 10 months from the initial detection of recurrence. This report presents a case of local recurrence of advanced rectal carcinoma, in which we were able to achieve a long-term survival and improvement in QOL by an intensive multidisciplinary therapy.
Yoshitani
Shinichiro
S
Dept. of Surgery II, Kanazawa Medical University.
Imaizumi
Hideko
H
Kuroda
Masatoshi
M
Yokoi
Miki
M
Tanaka
Yumiko
Y
Harada
Hideya
H
Kosaka
Takeo
T
Takashima
Shigeki
S
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005467:Floxuridine / Q000008:administration & dosage; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*
D005467:Floxuridine; D002945:Cisplatin; D005472:Fluorouracil; C025034:doxifluridine