ISSN:
1437-7772
Keywords:
Key words Rectal cancer
;
Signet-ring cell cancer
;
Dihydropyrimidine dehydrogenase
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract A 51-year-old man underwent low anterior resection for signet-ring cell carcinoma of the rectum. Pathological examination revealed the existence of cancer cells in the anal surgical margin, even though findings in the intra-operative pathological examination of the frozen sample were negative. After surgery, biochemical modulation, of sequential methotrexate and 5-fluorouracil as adjuvant therapy, was started. Intermediate doses of methotrexate (100 mg/m2 = 170 mg/body) and 5-fluorouracil (600 mg/m2 = 1000 mg/body) were administered 105 times over a period of 3 years and 10 months after the operation. Dihydropyrimidine dehydrogenase activity in peripheral blood was examined twice and found to be high (484 and 378 pmol/min per mg protein). This high dihydropyrimidine dehydrogenase activity may explain the patient's tolerance of 105 administrations of sequential methotrexate and 5-fluorouracil therapy. No recurrence had been detected by periodic colonoscopy, computed tomography, and ultrasonography until a recurrent tumor at the anastomotic site was recognized by colonoscopy 6 months after the last administration of the chemotherapy. After preoperative irradiation was carried out, abdominoperineal resection was performed. Two months after the second operation, he began a regimen of 5≧-doxifluridine (800 mg/day, orally), every day, and no further recurrence has been detected as of the time of this report (16 months after the second operation).
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/PL00012049
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