title: [A case of advanced rectal carcinoma with multiple lung metastases responding to irinotecan combined with 5-fluorouracil and l-leucovorin (IFL) as neoadjuvant chemotherapy (NAC)].
abstract: A 53-year-old man, admitted for inguinal hernia, complained of body weight loss in a preoperative condition check. We examined the digestive tract and diagnosed stage IV advanced rectal carcinoma with multiple lung metastases. It caused ileus, so emergency colostomy was performed. After that his general condition recovered, and two cycles of neoadjuvant chemotherapy (NAC) by irinotecan combined with 5-fluorouracil and l-leucovorin (IFL) therapy were performed on an outpatient basis. Lung metastatic nodules disappeared. We established a diagnosis of down staging for stage IIIa, and performed a lower anterior resection with D 2 lymph node dissection to allow a curability-A resection. The pathological effect of NAC was Grade 2. Post-operatively, two cycles of IFL therapy were then performed. There has been no sign of recurrence, and no adverse effects by chemotherapy have been seen during this treatment. Thus, NAC by IFL therapy can be one of the useful treatment approaches for patients with advanced rectal cancer.
authors.affiliation: Dept. of Surgery, Odawara City Hospital.
authors.forename: Tadaomi
authors.initials: T
authors.lastname: Fukada
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yasuno
authors.forename: Takashi
authors.initials: T
authors.lastname: Koyama
authors.forename: Hideo
authors.initials: H
authors.lastname: Tanaka
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Seike
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kametaka
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hayashi
authors.forename: Reiko
authors.initials: R
authors.lastname: Hashimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawano
authors.forename: Akio
authors.initials: A
authors.lastname: Hasegawa
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D017024:Chemotherapy, Adjuvant; D003125:Colostomy; D004334:Drug Administration Schedule; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000601:surgery; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*
chemical_list: D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin