[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: Masami Kimura, Daisuke Kuroda, Kosei Kawada, Hiroo Matsushita, Takumasa Nishimura, Yasuhiro Shimokawa, Akihiko Arakawa, Mitsuo Soh, Kazuhiko Date
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 41 Issue 8 Pg. 1017-20 (Aug 2014) ISSN: 0385-0684 [Print] Japan
• PMID: 25132037 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Drug Combinations
• S 1 (combination)
• Tegafur
• Oxonic Acid

Topics

• Antimetabolites, Antineoplastic (therapeutic use)
• Chemoradiotherapy
• Drug Combinations
• Humans
• Male
• Middle Aged
• Oxonic Acid (therapeutic use)
• Rectal Neoplasms (complications, therapy)
• Remission Induction
• Tegafur (therapeutic use)
• Time Factors
• Urinary Bladder Fistula (etiology)