One case report about multidisciplinary treatment of an advanced multiple primary colorectal cancer

doi:10.3877/cma.j.issn.2095-3224.2016.05.016

Abstract

Abstract:

In recent years, the incidence of colorectal cancer increased significantly, with the multidisciplinary team (MDT) mode is established, the survival time of colorectal cancer and advanced colorectal cancer patients have been significantly extended, the quality of life was effectively improved. The survival of the patient with advanced multiple primary colorectal cancer was 7 years. This patient get better control of the disease and maintain a high quality of life with the comprehensive treatment in MDT model. In this paper, we will report its treatment process and share some experience with you.

Key words: Colorectal neoplasms, Therapy, Multidisciplinary team (MDT), Experience of diagnosis and treatment

Liu Yang. One case report about multidisciplinary treatment of an advanced multiple primary colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2016, 05(05): 447-449.

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URL: https://zhjzcjbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3224.2016.05.016

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References 7

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时间	症状	检查	治疗	病情评估	PS评分
2009.2	发现右下腹包块	彩超示双附件囊性包块肿瘤标志物正常	剖腹探查术	CR	2
2009.5-7	无	病理会诊	FOLFOX4方案化疗3周期	SD	2
2009.7-2013.2	无	定期复查	中成药	SD	1
2013.3-5	便血	CEA、CA125升高，PET-CT示乙状结肠直肠交界处放射性浓聚灶，肠镜示距肛门10 cm肿块，病检示高级别上皮内瘤变	剖腹探查术，腹盆腔及腹膜广泛转移	PD	2~3
2013.5-6	便血	CEA、CA125下降，CT示肝多发转移（14 mm）	CPT-11＋L-OHP′1周期	PD	2~3
2013.6-7	乏力	CEA、CA125正常，影像学评估稳定	PTX＋L-OHP′1周期	SD	2~3
2013.7-8	乏力	CEA升高，CT示肝转移（13 mm）	TP′2周期	SD	2
2013.9-12	便血	CEA升高，CT示肝转移瘤增大（18 mm），肠镜示直肠及乙状结肠肿块，活检病理示直肠腺癌，乙状结肠见个别异型腺体	患者一般状况差暂停化疗	PD	2~3
2013.12-2014.4	便血好转	CEA缓慢升高	PTX＋FT-207′4周期	SD	2~3
2014.5-8	便血	CEA、CA125升高，CT示直肠及乙状结肠病灶较前增大	中成药	PD	3
2014.9.11	便血伴肠梗阻	CEA、CA125升高	剖腹探查术＋回肠造瘘术，KRAS基因为野生型	-	2
2014.10-11	无便血	CEA稳定，CT示直肠及乙状结肠病灶无变化	S1化疗2周期	SD	2
2014.12-2015.1	偶有腹痛	CEA升高，CT示直肠及乙状结肠病灶较前增大	S1化疗2周期	PD	1~2
2015.1-3	偶有便血	CEA升高，CT示直肠及乙状结肠病灶较前增大	CPT-11＋S1化疗2周期	PD	2
2015.4-6	偶有便血	CEA下降，CT示直肠及乙状结肠病灶无变化	CPT-11＋雷替曲塞化疗2周期	SD	2
2015.6-8	便血、乏力	CEA下降，CT示直肠及乙状结肠病灶无变化。	CPT-11＋雷替曲塞＋西妥昔单抗治疗2周期	SD	2~3
2015.8-2016.1	偶有腹痛	CEA下降，CT示直肠及乙状结肠病灶无变化	卡培他滨＋西妥昔单抗治疗6周期	SD	2
2015.9.22	肛门坠胀伴肿瘤脱垂	CEA稳定	经肛门局部肿瘤切除术	-	2~3
2016.1-2	无	CEA升高，CT示直肠及乙状结肠病灶增大	卡培他滨＋西妥昔单抗治疗6周期	PD	1
2016.2-3	无	CEA升高，CT示直肠及乙状结肠病灶增大	FOLFIRI＋西妥昔单抗治疗2周期	PD	1
2016.4-至今	下腹部坠胀	CEA稳定，CT示直肠及乙状结肠病灶无变化	FOLFIRI＋贝伐珠单抗治疗2周期	SD	1

时间	症状	检查	治疗	病情评估	PS评分
2009.2	发现右下腹包块	彩超示双附件囊性包块肿瘤标志物正常	剖腹探查术	CR	2
2009.5-7	无	病理会诊	FOLFOX4方案化疗3周期	SD	2
2009.7-2013.2	无	定期复查	中成药	SD	1
2013.3-5	便血	CEA、CA125升高，PET-CT示乙状结肠直肠交界处放射性浓聚灶，肠镜示距肛门10 cm肿块，病检示高级别上皮内瘤变	剖腹探查术，腹盆腔及腹膜广泛转移	PD	2~3
2013.5-6	便血	CEA、CA125下降，CT示肝多发转移（14 mm）	CPT-11＋L-OHP′1周期	PD	2~3
2013.6-7	乏力	CEA、CA125正常，影像学评估稳定	PTX＋L-OHP′1周期	SD	2~3
2013.7-8	乏力	CEA升高，CT示肝转移（13 mm）	TP′2周期	SD	2
2013.9-12	便血	CEA升高，CT示肝转移瘤增大（18 mm），肠镜示直肠及乙状结肠肿块，活检病理示直肠腺癌，乙状结肠见个别异型腺体	患者一般状况差暂停化疗	PD	2~3
2013.12-2014.4	便血好转	CEA缓慢升高	PTX＋FT-207′4周期	SD	2~3
2014.5-8	便血	CEA、CA125升高，CT示直肠及乙状结肠病灶较前增大	中成药	PD	3
2014.9.11	便血伴肠梗阻	CEA、CA125升高	剖腹探查术＋回肠造瘘术，KRAS基因为野生型	-	2
2014.10-11	无便血	CEA稳定，CT示直肠及乙状结肠病灶无变化	S1化疗2周期	SD	2
2014.12-2015.1	偶有腹痛	CEA升高，CT示直肠及乙状结肠病灶较前增大	S1化疗2周期	PD	1~2
2015.1-3	偶有便血	CEA升高，CT示直肠及乙状结肠病灶较前增大	CPT-11＋S1化疗2周期	PD	2
2015.4-6	偶有便血	CEA下降，CT示直肠及乙状结肠病灶无变化	CPT-11＋雷替曲塞化疗2周期	SD	2
2015.6-8	便血、乏力	CEA下降，CT示直肠及乙状结肠病灶无变化。	CPT-11＋雷替曲塞＋西妥昔单抗治疗2周期	SD	2~3
2015.8-2016.1	偶有腹痛	CEA下降，CT示直肠及乙状结肠病灶无变化	卡培他滨＋西妥昔单抗治疗6周期	SD	2
2015.9.22	肛门坠胀伴肿瘤脱垂	CEA稳定	经肛门局部肿瘤切除术	-	2~3
2016.1-2	无	CEA升高，CT示直肠及乙状结肠病灶增大	卡培他滨＋西妥昔单抗治疗6周期	PD	1
2016.2-3	无	CEA升高，CT示直肠及乙状结肠病灶增大	FOLFIRI＋西妥昔单抗治疗2周期	PD	1
2016.4-至今	下腹部坠胀	CEA稳定，CT示直肠及乙状结肠病灶无变化	FOLFIRI＋贝伐珠单抗治疗2周期	SD	1

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