Paraaortic lymph node metastasis showed CR to UFT/LV therapy in elderly rectal cancer

Intravenous chemotherapy with a combination of several drugs is commonly used to treat metastatic colorectal cancer. However, the associated adverse events can be severe. Here we report a rare case of metastatic rectal cancer in an elderly patient who got complete response for metastatic rectal cancer with oral uracil-tegafur plus leucovorin therapy.

77-year-old male. An abdominoperineal resection of the rectum was performed, but para-aortic lymph-node metastasis occurred. Uracil-tegafur plus leucovorin therapy was started on postoperative day 48. Each chemotherapy course comprised 400 mg/day uracil-tegafur and 75 mg/day leucovorin administered for 28 days every 35 days.

After 10 courses, abdominal computed tomography indicated that a good partial response had been achieved. The para-aortic lymph-node swelling disappeared after 17 courses, indicating a complete response. During this period, no adverse events were noted. No recurrence had occurred 4 months after the complete response.

This case demonstrates that uracil-tegafur plus leucovorin therapy can be used safely even in elderly patients, and suggests that it is likely to be effective in treating metastatic colorectal cancer.