title: [A case of a patient with advanced rectal cancer and urinary bladder fistula surviving for 6 years after chemoradiotherapy without surgery].
abstract: A 60-year-old man with advanced rectal cancer and urinary bladder fistula received preoperative chemoradiotherapy with S-1(120mg/m / 2day)on weekdays and concurrent radiotherapy(65 Gy). After chemoradiotherapy, the clinical symptoms resolved and the tumor shrunk, as observed on endoscopic and radiologic examinations. However, remnant cancer was suspected; therefore, modified oxaliplatin, 5-fluorouracil, and Leucovorin(mFOLFOX6)therapy was initiated, although it was stopped after 3 cycles because of numbness in the lower extremities. Finally, clinical and pathological complete response(CR) was achieved by administering additional doses of S-1 for approximately 1 year after treatment initiation; CR was confirmed by using endoscopy and computed tomography(CT), and there has been no recurrence for 6 years. This case suggests that treatment without surgery is a viable alternative for advanced rectal cancer with pathological CR after chemoradiotherapy.
authors.affiliation: Dept. of Surgery,Health Insurance Hitoyoshi General Hospital.
authors.forename: Masami
authors.initials: M
authors.lastname: Kimura
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kuroda
authors.forename: Kosei
authors.initials: K
authors.lastname: Kawada
authors.forename: Hiroo
authors.initials: H
authors.lastname: Matsushita
authors.forename: Takumasa
authors.initials: T
authors.lastname: Nishimura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimokawa
authors.forename: Akihiko
authors.initials: A
authors.lastname: Arakawa
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Soh
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Date
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D004338:Drug Combinations; D006801:Humans; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000627:therapeutic use*; D012004:Rectal Neoplasms / Q000150:complications / Q000628:therapy*; D012074:Remission Induction; D005641:Tegafur / Q000627:therapeutic use*; D013997:Time Factors; D001747:Urinary Bladder Fistula / Q000209:etiology*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid