title: [Long-Term Successful Management of Recurrent Rectal Cancer in the Predialysis State with FOLFIRI Chemotherapy].
abstract: A 71-year-old man with predialysis terminal renal insufficiency experienced peritoneal dissemination 1.5 years after low anterior resection for advanced rectal cancer. He received FOLFIRI therapy (70% dose); he achieved partial response (PR) under computed tomography and stable disease (SD) was maintained over a long term. Although Grade 3 myelosuppression was occasionally noted, he was treated with FOLFIRI for 2 years without other severe complications and without requiring the initiation of hemodialysis. After the initiation of hemodialysis, FOLFIRI treatment was continued for 1 year until progressive disease (PD). He received mFOLFOX6 as second-line therapy for 6 months, followed by LV-5-FU and a molecular targeting agent. These treatments prolonged his survival for 1 year and 8 months. FOLFIRI can be administered as an effective first-line therapy even for patients with predialysis terminal renal impairment without major renal damage. FOLFOX and molecular targeting agents should be made available and prolonged survival can be expected for advanced colorectal cancer patients with terminal renal disease after the initiation of hemodialysis.
authors.affiliation: Dept. of Surgery, Seirei Sakura Citizen Hospital.
authors.forename: Naoto
authors.initials: N
authors.lastname: Koike
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fujii
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ohshima
authors.forename: Seiji
authors.initials: S
authors.lastname: Arita
authors.forename: Naohide
authors.initials: N
authors.lastname: Isaka
authors.forename: Eiji
authors.initials: E
authors.lastname: Shinozaki
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003956:Dialysis; D017809:Fatal Outcome; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D012004:Rectal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D012008:Recurrence; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*; D013997:Time Factors
chemical_list: D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin