title: [Recurrent rectal cancer with multiple liver and lung metastases treated effectively with oxaliplatin and capecitabine plus bevacizumab chemotherapy-a case report].
abstract: A 60-year-old woman receiving treatment for diabetes underwent laparoscopic-assisted low anterior resection and was diagnosed as having rectosigmoid cancer in January 2010( pSS, n2[ +], sM0 fStage IIIb, mutant-type K-ras). She refused adjuvant chemotherapy. In July, after surgery, chest-abdominal-pelvic computed tomography( CT) scans showed bilateral lobe multiple liver metastases and right lobe lung metastases. We recommended oxaliplatin and capecitabine (CapeOX) plus bevacizumab( BV) chemotherapy or surgery. The CapeOX plus BV regimen was initiated at the patient's request. After 8 cycles of chemotherapy, a partial response was observed in the metastatic liver tumors and stable disease was observed in the lung metastases. As hypertension appeared after 16 cycles of chemotherapy, we switched the treatment to CapeOX. After 10 cycles of CapeOX, the chemotherapy was changed to capecitabine at the patient's request owing to the development of grade 2 chronic peripheral neuropathy. Chest-abdominal-pelvic CT scans after 32 cycles of this regimen revealed shrinkage of the multiple liver metastases. The patient has been receiving treatment as an outpatient. Surgical resection should be considered for patients with initially unresectable colon cancer with liver and/or lung metastases if systemic chemotherapy is effective.
authors.affiliation: Dept. of Surgery, Ogikubo Hospital.
authors.forename: Nobushige
authors.initials: N
authors.lastname: Yabe
authors.forename: Shinji
authors.initials: S
authors.lastname: Murai
authors.forename: Hirotomo
authors.initials: H
authors.lastname: Shimizu
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kitasato
authors.forename: Takahisa
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Ippei
authors.initials: I
authors.lastname: Oto
authors.forename: Junpei
authors.initials: J
authors.lastname: Nakadai
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D000069287:Capecitabine; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000601:surgery; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D012008:Recurrence; D012811:Sigmoid Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000068258:Bevacizumab; D000069287:Capecitabine; D005472:Fluorouracil