[通过多学科治疗管理不可切除的西格结肠癌病例的长期存活]
Ryosuke Machi1, Daisuke Yamamoto, Hiroshi Saito
1Dept. of Gastrointestinal Surgery, Kanazawa University Hospital.
Gan to kagaku ryoho. Cancer & chemotherapy
|October 27, 2025
概括
具有广泛转移的晚期结直肠癌可以通过多学科的治疗策略来管理. 这个案例证明了通过肝脏和淋巴结转移的联合疗法来实现长期生存.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 第四阶段的西格莫伊德结肠癌与肝脏和副大动脉淋巴结 (PALN) 扩散转移是一个重大的临床挑战.
- 最初的表现包括血和腹部下部疼痛,表明疾病已晚.
研究的目的:
- 描述最初无法切除的IVb期西格体结肠癌的多学科治疗方法.
- 突出结合化疗,向治疗和手术干预在实现长期生存方面的有效性.
主要方法:
- laparoscopic sigmoid colectomy 之后是 FOLFOXIRI 加上贝瓦西祖马布化学疗法.
- 在显著的瘤减少和完整的PALN反应后,随后的肝切除.
- 通过重复切除肝脏,PALN剖析和化学辐射疗法来管理多次复发.
- 在以后的治疗线路中重新引入oxaliplatin和启动fruquintinib.
主要成果:
- 在初始化疗后,肝转移的显著减少和PALN转移的完全响应.
- 通过新辅助疗法实现了成功的肝切除.
- 实现了6年3个月的整体生存期.
- 证明了重复手术和连续化疗方案的可行性.
结论:
- 涉及手术,化疗 (FOLFOXIRI加贝瓦西祖马布) 和向治疗的多学科策略对于管理最初无法切除的结直肠癌至关重要.
- 积极的治疗,包括重复切除和连续治疗,可以导致晚期结直肠癌患者的生存时间延长.
- 这一案例强调了量身定制,逐步方法在优化复杂的转移性结直肠癌病例的结果的重要性.
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