Case report of two colorectal cancer patients with liver metastasis showing favorable response to fluorouracil and l-leucovorin therapy

摘要

We treated 2 patients with colorectal cancer accompanied by liver metastasis who showed favorable response to combined treatment with fluorouracil and l-Leucovorin. Case 1 was a 40-year-old man with rectal carcinoma (moderately differentiated adenocarcinoma; se, n1, p1, H0, stage IV). He underwent low anterior resection of the rectum and postoperatively showed an increase peritoneal dissemination and liver metastasis. The patient was given 600 mg/m2 fluorouracil and 250 mg/m2 l-Leucovorin concomitantly for 7 courses. At course 3, the liver metastasis showed partial response and, during the 18 months after the 7th course, his peritoneal dissemination and other lesions were well controlled. As of 30 months post-treatment the patient was alive. Case 2 was a 60-year-old man with rectal carcinoma (well differentiated adenocarcinoma; ss, n1, p0, H1, stage IV). He underwent low anterior resection and postoperatively was given 3 courses of fluorouracil and l-Leucovorin. At course 2, he showed complete response, and, at present 8 months after the 2 courses, the patient continues to show complete response. Adverse drug reactions in both patients were controlled on an outpatient basis. While in the past liver metastasis has been treated by hepatic arterial infusion chemotherapy, a combination therapy with fluorouracil and l-Leucovorin can be used on an outpatient basis and results in a favorable response. This suggests that this combination therapy has clinical significance.